脾扭转1例
Chinese Journal of Medical Imaging Technology（2018）
Abstract
患儿男,17岁,因“间断腹痛、呕吐4天”入院.查体:左腹部压痛,无反跳痛,脾肋下2 cm,肝未触及.实验室检查:外周血白细胞4.64×109/L,血红蛋白142 g/L,血小板60×109/L,异型淋巴细胞百分比9％.CT:平扫见脾脏明显肿大、下移,脾脏上下极反转、倒置,实质密度尚均匀(图1A);增强扫描见脾动、静脉呈旋涡状改变,脾实质未见明显花斑样强化(图1B、1C).CT诊断:考虑脾扭转.行腹腔镜下脾切除术,术中见脾脏瘀血、肿大,约30 cm×25 cm×10 cm,边缘粗钝,全脾均呈暗红色,质地脆,易出血;脾蒂水肿、增粗,呈暗红色,扭转约180°.
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