阴囊内副脾异位1例

1病例报告患者男,21岁,汉族。出生后家人即发现其左侧阴囊内有一包块,8岁时阴囊内包块仍存在,但无任何不适,在外院曾诊断为“腹股沟斜疝”,因无症状未行治疗。近一年来,发现阴囊内包块已逐渐增大至鸽蛋大小,以“左附睾囊肿”收治入院。无特殊家族史。体检:外阴及双侧睾丸发育正     

左肾上腺区异位副脾1例

病例女,27岁,因发现高血压2年入院.入院查体:血压90/130 mmHg,血钾3.23 mmol/L,血醛固酮、皮质醇、多巴胺、肾上腺素及去甲肾上腺素均正常,尿多巴胺及去甲肾上腺素增高.超声检查:左肾上极与脾门之间探及一类圆形减低回声结节,大小约2.2 cm×2.1 cm,边缘欠光滑,内部回声欠均匀;彩色多普勒显示结节周边见少许血流信号,内部未见明显血流信号.超声报告:左肾上腺区实性减低回声占位,结合临床考虑为左肾上腺嗜铬细胞瘤.手术所见:左侧肾上腺区与腹膜移行处见大小约3 cm×2.5 cm×2 cm包块,暗红色,与脾门粘连,行包块切除术.病理结果:包块为脾脏组织,符合副脾.     

异位脾误诊为卵巢肿瘤1例

1　病历简介患者女 ,3 4岁 ,Ｇ2Ｐ1+ 1,因“发现盆腔包块 4+ 年 ,“Ｂ”超揭示包块增大 4天”入院。患者入院前 4+ 年 ,因“经量过多”在外院“Ｂ”超检查提示左附件整肿约 2× 2× 1.5ｃｍ3 ,未治疗 ,但定期 ( 3～ 6个月 )“Ｂ”超检查 ,其包块无明显的改变。入院前 4天 ,患者再欠复查“Ｂ”超 ,提示左附件实性肿物约 4× 4× 3ｃｍ3 ,无腹水 ,无月经的改变 ,无腹痛 ,其后多次复查“Ｂ”超均为相同提示 ,遂来院手术治疗。既往史 :患者 6岁时因外伤致脾破裂 ,行脾切除术。入院查体 :Ｔ3 6.8℃ ,Ｐ82次 /分 ,Ｒ2 0次 /分 ,ＢＰ112 /71ｍｍＨ…     

胰腺内异位副脾的CT诊断(附2例报道)

目的:探讨胰腺内异位副脾(IPAS)的CT表现,从而提高对本病的认识能力及诊断水平。方法:搜集经手术病理证实的2例IPAS患者的完整病例资料,结合文献分析其CT表现。结果:2例IPAS均位于胰尾部,1例在动态增强CT扫描各期,IPAS的强化程度与强化方式均与脾脏相似,动脉期为不均匀强化,门静脉期均匀强化,且密度均高于胰腺;另1例表现为动脉期轻度均匀强化,且动静脉期密度均低于胰腺。结论:IPAS多为单发的圆形或卵圆形、边界清晰的实质性肿块,位于胰腺尾部尖端或非常接近胰腺尾部尖端处,在CT增强扫描各期其强化程度与强化方式均与脾脏相似,动脉期表现为不均匀强化等特征均有助于IPAS的诊断。     

盆腔异位脾一例

异位脾也可称为游走脾、漂浮脾、脾下垂 ,1888年由Ｂｏｎｄ首次报道 ,是 1种少见的先天性异常[1] 。笔者遇 1例脾脏位于盆腔的患者 ,报告如下。患者女 ,2 3岁。腹部肿块 ,伴不完全肠梗阻 3个月余。ＣＴ检查示右下腹软组织密度肿块影 (图 1) ,形状不规则 ,轮廓较清晰 ,膀胱及周围肠管受压 ;脾脏区未见脾脏影 (图 2 ) ;彩色多谱勒检查见盆腔内脾脏回声 ,体积增大 ,血流丰富 ,并可见偏前方的脾门。诊断 :盆腔异位脾 (图 3)。行手术治疗 ,术中探查左季肋下脾窝脾脏缺如 ,于盆腔找到脾脏 ,常规切除脾。术后病理诊断 :游离脾 ,脾脏淤血伴中性粒细…     

异位胰腺1例

1　病例报告患者女 ,4 5岁 ,因间歇性右上腹胀痛 ,伴右肩背部不适10个月入院。 1年前因胆结石伴胆囊炎在外院行腹腔镜胆囊切除术 ,术后 2个月出现间歇性右上腹胀痛 ,症状逐渐加重。查体 :体温 36 5℃ ,脉搏 80 /ｍｉｎ ,呼吸 18/ｍｉｎ ,血压14 0 / 9 0ｋＰａ。全身无黄染。腹平软 ,全腹未触及包块 ,右上腹压痛、无反跳痛。实验室检查 :血、尿、便常规及肝功、生化均正常。Χ线胸透、心电图正常。Ｂ超示胆总管扩张伴结石 ,肝、脾、胰无异常。诊断 :胆总管结石。行胆总管探查、Ｔ形管引流术时发现胃窦部距幽门管 6ｃｍ处胃壁上有一 1 5ｃｍ…     

右肾上腺区异位种植脾1例

1病例报告 患者女,53岁。因右侧上腹部间歇性疼痛3年加重1个月入院。查体：血压140／90mmHg,浅表淋巴结未触及,心肺无异常,腹平软,右上腹轻度压痛,无反跳痛,双肾及输尿管走行区无压痛。患者高血压病史10余年,服药物控制血压水平尚可。16年前因车祸致脾破裂行脾切除术。     

胆囊结石胆囊炎合并异位胰腺1例

异位胰腺又称迷走胰腺、副胰腺，临床上极少见，手术前诊断困难，易漏诊、误诊，一经确诊，手术切除是有效及可靠的方法。本院2002年7月收治1例胆囊结石胆囊炎合并异位胰腺病人，术前诊断为胆囊结石胆囊炎，术后病理诊断；胆囊结石胆囊炎合并异位胰腺。现报告如下。     

Intrapancreatic accessory spleen: diagnosis using contrast enhanced ultrasound

Intrapancreatic accessory spleen (IPAS) is a mass that can mimick a neoplastic mass in the pancreas. As it poses no clinical problem no treatment is required. Unfortunately almost all the reported cases of IPAS have been misdiagnosed and unnecessary surgery performed. We performed contrast-enhanced ultrasound (CEUS) in a patient with IPAS for a research purpose, and confirmed that CEUS is useful for diagnosing this entity.     

Intrapancreatic accessory spleen mimicking pancreatic mass on CT.

Accessory spleens occur in approximately 10% of the population and are usually located in the region of the splenic hilum. In 16% of patients the accessory spleen will be located within the pancreatic tail. The diagnosis of an intrapancreatic accessory spleen can be suggested when CT, with and without intravenous contrast agent, demonstrates that the mass enhances in a manner identical to the spleen.     

Ultrasound detection of spontaneous rupture of accessory spleen: A case report

Accessory spleen rupture can induce acute abdominal bleeding following minimal trauma or by atraumatic mechanisms. Spleen rupture is more frequent in pediatric patients and those affected by hematological diseases. We described the case of a 59-year-old male patient affected by hereditary spherocytosis referred to the emergency department for abdominal left side pain. An early ultrasound performed in the emergency department allowed to diagnosed hemoperitoneum by spontaneous bleeding of hypertrophic accessory spleen. Although abdomen computed tomography is the diagnostic method of choice, ultrasound can early detect sign of emoperitoneum in the emergency setting in case of hemodinamically unstable patient.     

Preoperative angioembolisation of a mediastinal accessory ectopic spleen: A case report and review of the literature

A 50-year-old male presented to our institution for embolization of an incidentally detected mediastinal mass prior to surgical resection. The patient had undergone extensive pre-procedural imaging as well as bronchoscopy and mediastinoscopy. Ultimately, resection was required for a definitive diagnosis of congenital ectopic mediastinal accessory spleen. This case represents the first reported incidence of ectopic splenic tissue in this location and illustrates the difficulties in establishing a pre-operative diagnosis with often confounding imaging findings.     

Inflammatory myofibroblastic tumor of the spleen: a case report

Inflammatory myofibroblastic tumors (IMTs), otherwise known as the inflammatory pseudotumor, is a rare solid mesenchymal tumor, simulating malignant neoplasms, histologically characterized by the proliferation of spindle cells in a fibrous myxoid stroma containing inflammatory cells. CT and MR imaging are the most used tools in their assessment. Clinical features are nonspecific and depend on the localization of the tumor, radiologic findings are polymorphic and no-conclusive and present a diagnostic challenge to the radiologist. Although histology remains obligatory for the final diagnosis. Heren, we report a case of splenic IMT with histological correlation.