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| 1 | Abscesses of the spleen:Report of three cases显示文摘Abscess of the spleen is a rare discovery, with about 600 cases in the international literature so far. Although it may have various causes, it is most usually associated with trauma and infections of the spleen. The latter are more common in the presence of a different primary site of infection, especially endocarditis or in cases of ischemic infarcts that are secondarily infected. Moreover, immunosuppression is a major risk factor. Clinical examination usually reveals a combination of fever, left-upper-quadrant abdominal pain and vomiting. Laboratory findings are not constant. Imaging is a necessary tool for establishing the diagnosis, with a choice between ultrasound and computed tomography. Treatment includes conservative measures, and surgical intervention. In children and in cases of solitary abscesses with a thick wall, percutaneous catheter drainage may be attempted. Otherwise, splenectomy is the preferred approach in most centers. Here, we present three cases of splenic abscess. In all three, splenectomy was performed, followed by rapid clinical improvement. These cases emphasize that current understanding of spleen abscess etiology is still limited, and a study for additional risk factors may be necessary. | Constantin Fotiadis Giagkos Lavranos Pavlos Patapis Gabriel Karatzas | 2008 | World Journal of Gastroenterology2008，14，19： | 3 |
| 2 | 胃肠肿瘤伴发的脾脓肿4例临床分析与文献复习显示文摘目的讨论总结胃肠肿瘤伴发脾脓肿的临床表现及治疗,强调胃肠道肿瘤可继发脾脓肿,需引起临床医师重视。方法回顾2012年1月-2016年12月诊治的4例胃肠肿瘤伴发的脾脓肿患者的临床资料,分析其一般情况、基础疾病、临床表现、影像学特征、病原学特点、治疗方法和病情转归等,并进行文献复习,总结胃肠肿瘤伴脾脓肿患者的临床特点。结果4例胃肠肿瘤患者,其中2例胃腺癌、1例胃间质瘤以及1例结肠腺瘤;胃肠道肿瘤伴发的脾脓肿临床表现并无特异性,主要表现有发热、左上腹疼痛及白细胞总数升高,而影像学则表现为脾脏多发或单发的不规则低密度灶;2例病原菌为大肠埃希菌,其中1例患者为大肠埃希菌和屎肠球菌的混合感染,1例为粪肠球菌,另1例未明确病原菌。文献复习显示结肠脾曲的肿瘤可继发脾脓肿,此类患者以男性多见,病原菌多为大肠埃希菌。结论胃肠肿瘤因手术血运关系可能导致脾脓肿,应引起临床警惕。 | 岳巧艳 朱丽莹 黄金伟 申玉英 | 2018 | 中国感染与化疗杂志2018，18，4： | 2 |
| 3 | 结直肠癌脾转移3例显示文摘目的:探讨结直肠癌脾转移的临床特征及诊治.方法:回顾分析河北医科大学附属唐山工人医院2003-2008年3例结直肠癌脾转移的临床特征、诊断、治疗及预后.结果:3例结直肠癌脾转移患者,1例结肠癌术后行PET/CT检查确诊,其余2例均诊断为脾脓肿,2例行脾切除术,1例行剖腹探查术确诊,术后2wk死亡1例,其余2例已存活2、6年.结论:结直肠癌脾转移少见,临床误诊率高,影像学检查有助于诊断.脾脓肿患者应注意是否同时伴有结直肠癌,并行进一步检查.孤立的脾转移手术效果好. | 王军 张宝良 郭德智 袁庆鑫 | 2011 | 世界华人消化杂志2011，19，3： | 2 |
| 4 | 结直肠癌孤立性脾转移一例显示文摘患者女,57岁。2007年1月因“大便习惯改变3个月”,肠镜检查提示为“乙状结肠癌”收住入院。既往无重要器官疾病史,体格检杏未见明显异常,术前肠镜及病理活榆提示乙状结肠中分化腺癌,胸片及腹部cT榆查均未发现其他部位的远处转移,血清CEA63.21ng/ml。行乙状结肠癌根治术,病理学检查为中分化腺癌,肿瘤浸润至浆膜层(m),无血管和周围神经的侵犯,淋巴结4/t2转移(PN2a), | 史东波 柯孔亮 王红卫 | 2012 | 中华普通外科杂志2012，27，2： | 2 |
| 5 | 升结肠癌伴脾转移1例并文献复习显示文摘1病例介绍患者,男,53岁。患者2009年因"大便带血3月余"就诊当地医院,肠镜提示结肠癌,遂于2009年8月27日行"结肠癌根治术",术后病理:升结肠低分化管状腺癌,浸润深肌层,肠系膜淋巴结共5枚未见癌累及。脉管神经有无累及并未回报。术后1个月内患者在我院开始行改良FOLFOX6方案化疗12次。后患者规律随诊未见异常。2010年6月患者按期复查时发现CEA增高(39μg.L-1),后复查呈进行性增高,但影像学均无转移证据。 | 闫滢 何义富 胡冰 季楚舒 | 2013 | 安徽医药2013，17，3： | 1 |
| 6 | Isolated splenic metastasis from colon cancer: Case report显示文摘Isolated splenic metastases from colorectal cancer are very rare clinical entities and when they are present, they usually manifest widely disseminated disease. In this paper we report a case of metachronous solitary isolated splenic metastasis from colon cancer in a 64-year-old woman who was successfully treated by laparoscopic splenectomy. We discuss the pathological and clinical aspects of this condition. We furthermore comment on the diagnostic and therapeutic options of this rare entity through our observation of the case and consideration of the 31 case reports published in the literature. | Jiddou Abdou Youssef Omor Saber Boutayeb Basma Elkhannoussi Hassan Errihani | 2016 | World Journal of Gastroenterology2016，22，18： | 0 |
| 7 | Splenectomy for splenic metastases from malignant adrenal pheochromocytoma: a case report显示文摘Splenic metastasis is generally not a common clinical event. However, metastasis to the spleen from adrenal pheochromocytoma is extremely rare and has not been reported in literature. This report presents a case of a 58 year-old male patient who developed spleen-only metastases in July 2007. The patient had a previous history of left epinephroectomy for adrenal pheochromocytoma in January 2003. Abdominal computed tomography demonstrated multiple enhancing lesions suggestive of metastases; thus splenectomy was performed. Pathological examinations confirmed the diagnosis of splenic metastases from pheochromocytoma. The patient was alive without recurrence 48 months after splenectomy. This study is the first report on splenic metastasis from previous adrenal pheochromocytoma, and long-term survival was achieved by splenectomy. A history of malignancy indicates a high index of suspicion for splenic metastasis, and long-term survival can be achieved by splenectomy for spleen-only metastasis. | Xiao-Feng Duan | 2013 | Cancer Biology & Medicine2013，10，2： | 0 |
| 8 | 结肠癌伴脾转移患者一例显示文摘女性患者,56岁,因“大便性状改变伴腹痛3个月”于2013年7月入院。专科查体:腹部平软,无压痛及反跳痛,未触及肿块。肛门指检:直肠黏膜光滑,未触及肿块。结肠镜检查示:距肛门距离25 cm处见一大小约0.5 cm ×0.5 cm的息肉,亚蒂,进镜约70 cm横结肠近脾曲处见一环状结节状肿物,致肠腔狭窄,内镜无法通过。病理提示:25 cm处为息肉,70 cm处为腺癌。腹部CT示:结肠脾曲癌,侵及浆膜面,肠周见稍大淋巴结;部分横结肠管壁增厚水肿;肝囊肿;左肾囊肿;盆腔少量积液,脾脏未见明显病变。 CEA 为39.1 ng/ml。患者于2013年7月30日行左半结肠癌根治术,术中探查情况:无腹水,肝脏未见异常。腹盆腔、大网膜,脾脏未见转移结节,横结肠近脾曲扪及6 cm质硬缩窄型肿块,占肠腔一周,累及全层和周围组织。术中诊断为横结肠脾曲癌伴不全肠梗阻。术后病理为溃疡型腺癌,分化II~III级,癌组织浸润肠壁浆膜层,两切缘未见癌组织累及,肠系膜根部淋巴结(1/8),肠旁淋巴结(1/15),另见癌结节2枚。术后病理分期pT3 N2 M0。该患术后恢复良好, CEA值恢复正常。第14天开始接受奥沙利铂加5-FU加亚叶酸钙方案(mfolfox6)辅助化疗。其后一直在我院门诊接受化疗。在术后化疗过程中发现CEA值升高,术后3个月於2013年10月测CEA值为31.55 ng/ml,随后复查均波动于30~40 ng/ml,2013年11月在我院行PET-CT示:左半结肠癌术后,脾脏糖代谢增高的稍高密度灶,考虑转移可能(图1),其他部分未发现转移灶。经过多学科讨论( CRCMDT )后于2013年11月20日行脾切除术,术中探查:无腹水,左上腹有原手术粘连,肝脏未及转移结节,脾脏正常大小,仅在脾下极触及2 cm大小肿块,质硬,边界尚清。结合术前检查术中诊断为结肠癌术后、脾占位、脾转移可能。脾切除术后标本剖验示:病灶为淡黄白色,有7个可见病灶,同周围界限尚清,无坏死(图2)。术后病理:(脾脏)腺癌(7个病灶散布于脾脏各个部位,下极稍多),分化II~III级,伴坏死。结合病史,符合结肠腺癌脾脏转移。该患术后CEA值恢复到正常水平。鉴于患者在辅助化疗期间肿瘤出现转移,CRCMDT也将脾切除术后的化疗方案更改为伊立替康加5-FU 加亚叶酸钙方案( FOLFIRI )化疗12周期,目前第二次术后5月,接受FOLFIRI化疗9周期,随访无临床不适症状,复查胸腹部CT未发现远处癌转移。肿瘤标志物CEA值在正常范围。 | 吴晓华 韦烨 | 2014 | 中华结直肠疾病电子杂志2014，3，1： | 0 |
| 9 | 结肠脾曲癌慢性穿孔致脾脓肿、脾转移和结肠脾瘘一例显示文摘结肠癌是常见的消化道恶性肿瘤之一,发病率在胃肠道肿瘤中居第三位[1]。其典型表现为排便习惯的改变,如便血、腹泻或便秘、肠梗阻等,及由此引起的全身症状,如消瘦、贫血和乏力等。部分结肠癌尚可因癌肿侵蚀或肠梗阻肠内压升高引起肠穿孔和腹膜炎[2]。但结肠癌慢性穿孔、侵犯脾脏引起脾脓肿、脾转移、结肠脾瘘较为罕见。本文报道1例结肠脾曲癌伴脾脓肿、脾转移和结肠脾瘘,结合文献分析其诊治策略。 | 王鹏 王东 黄晨 陈晓鹏 | 2023 | 肝胆胰外科杂志2023，35，4： | 0 |
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