摘要
病人為11歲之女孩，於住院前4個月卽注意到左上腹部有間斷發生的鈍痛，尤其當她跑步或作其他運動時更明顯。於本院作腹部超音波檢查，發現在左上腹部有一音波透過之囊狀影，懷疑是脾臟囊腫而住院診治。理學檢查除在左肋下緣一指幅處可摸到表面平滑、有壓痛之脾臓外，其餘都正常。實驗室檢查亦無異常發現。胸部X光顯示左側橫膈膜稍有上昇。腹部X光並沒有發現鈣化點。放射線同位素((上標 99m)Tc）肝脾掃描發現於脾臟上極有一灌注缺陷處。下消化鋇劑灌腸攝影顯示大腸脾彎處受一外力壓迫而向前向下異位。靜注腎臟攝影可見左側腎臟明顯地下降。心電圖檢查正常。 在脾臟囊腫的診斷下進行剖腹手術，發現於脾臟之上極長有一柔軟平滑之襄腫。作了脾臟切除術，脾臓大小為12×10×5cm，而上極有一6×5×4.5cm 的囊腫。脾臟重370gm，切開後流出220ml稻草色的液體，此時脾臟重140gm。囊腫的內壁有許多厚且富有小樑的纖維帶。顯微鏡下囊腫的內側大部份被覆着一層扁平上皮細胞，而一部份則為重層鱗狀上皮細胞。無寄生蟲感染或血管瘤的徵據。此為一真性囊腫。開刀後病人在情況穩定下出院。
關鍵字
無資料並列摘要
A case of true splenic cyst in an eleven-year-old girl is reported. She appeared to be quite healthy except occasional vague pain in the left hypochondrium had bothered her for more than four months. A correct clinical diagnosis based on clinical findings, such as abdominal sonography, liver-spleen scintiscan, contrast lower intestinal studies and intravenous pyelogram was made preoperatively. The history, classification and treatment of this disease are also reviewed and discussed.
延伸閱讀
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