Laparoscopic Splenectomy for Wandering Spleen with Immune Thrombocytopenic Purpura—A Case Report—
نویسندگان
چکیده
症例は25歳の女性．左側腹部痛を主訴に近医を受診し汎血球減少を指摘され，当院血液内科を紹介受診した．血液疾患や悪性腫瘍，膠原病は否定的であり，遊走脾と脾腫を認めた．脾腫による汎血球減少と診断し，腹痛が改善したため経過観察とした．初診から13年後，皮下出血と血尿が出現し，高度な血小板減少（血小板数0.1×104/mm3）を認めた．脾腫の増悪や脾臓の明らかな茎捻転を疑う所見を認めず，骨髄生検で芽球の増生はなく，巨核球が増加していた．以上の所見から，免疫性血小板減少性紫斑病（immune thrombocytopenic purpura:以下，ITP）を合併したと考え，ステロイドとトロンボポエチン受容体作動薬で加療したが，血小板減少の改善効果に乏しく腹腔鏡下脾臓摘出術を施行した．術後徐々に血小板数が増加し，術後6カ月時点で血小板減少の再燃なく経過している．遊走脾による脾腫にITPを併発したと考えられた高度な血小板減少をきたしたまれな1例を経験したので報告する．
منابع مشابه
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Objectives: Accessory spleens are foci of splenic tissue found commonly adjacent to the main spleen. Incidence ranges from 10 to 20% in general population. However, they occur with a higher frequency in patients with hematologic diseases. Immune Thrombocytopenic Purpura (ITP) stands out amongst these illnesses, and a detailed identification of these foci is extremely necessary to guarantee the ...
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ژورنال
عنوان ژورنال: Nihon Rinsho Geka Gakkai Zasshi (journal of Japan Surgical Association)
سال: 2022
ISSN: ['1345-2843', '1882-5133']
DOI: https://doi.org/10.3919/jjsa.83.422