JOURNAL OF CLINICAL SURGERY ›› 2020, Vol. 28 ›› Issue (6): 554-556.doi: 10.3969/j.issn.1005-6483.2020.06.016
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Abstract: Objective:To summarize five cases of hepatic splenosisin to improve diagnostic accuracy.Methods:Five hepatic splenosis cases confirmed by pathology from 2013 to 2018 were collected in our hospital.Clinical characteristics including age,gender,past history,physical examination,liver function as well as tumor markers,imaging,surgical findings,pathological examination and followups were analyzed.Results:All the patients with good performance status were male,aging from 33 to 52 years,average 45 years.All of them experienced trauma and splenectomy,time interval of which was 16.4 years on average,and left surgical scars on abdomen.ChildPugh was grading as A.No abnormality was found for tumor markers.Ultrasonography showed hypo or isoechoic lesion with clear boundaries.The lesions were presented as hypodensity mass in plain CT scan,enhanced in arterial phase and decreased to isodensity in delayed phase for contrastenhanced CT.MRI displayed long T1 and long T2,slight hyperintensity or unchanged in DWI.PWI was similar to that of CT.The patients underwent surgical treatments,four of them received laparoscopic partial hepatectomy with sufficient surgical margin.Six lesions with intact capsules were discovered in segment 2,4,6 and 8,ranging from 1.5 to 5cm in diameter.Average operation time was 186 minutes,and blood loss was 100 ml.No transfusion,lesion rupture and hepatic blood occlusion appeared.The patients discharged uneventfully,5 to 9 days after surgery.All tumors were identified as spleen tissues by histology examination.No recurrence was found during the followups.Conclusion:History of splenic trauma or splenectomy is helpful for the diagnosis of hepatic splenosis.Laparoscopic exploration is recommended for uncertain cases.
Key words: hepatic splenosis, partial hepatectomy
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