Splenic pseudocyst associated with choledocholthiasis: Case report

• Published in: Japanese Journal of National Medical Services Vol. 43; no. 4; pp. 462 - 464
• Main Authors: KIMURA Shinetsu, TAKANO Masumi, MARUGAMI Yoshihisa, HOHJYO Masahisa, KIKUYAMA Shigehiro, YANO Yoshiaki, HASHIMOTO Toshio, TOMITA Tohji, NISHIDA Kazumi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1989; 一般社団法人 国立医療学会
• Subjects: 仮性嚢胞; 摘脾; 脾嚢胞
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.43.462

Though splenic pseudocyst was so far considered to be a relatively rare disease, the number of reports of this lesion has increased gradually with recent advances in image diagnosis. In the present article, a case of splenic pseudocyst complicated with choledo-cholithiasis experienced in our department is reported with review of the literatures.The subject was a 74 year old female who had undergone cholecystectomy because of gall stones in 1975. In 1987, she was admitted to our hospital because of upper abdominal pain. At the preoperative examinations, choledocholithiasis was found with a markedly swollen spleen. A low density area extending from the subcapsular upper pole to the outside region of the spleen was observed by CT scanning. Celiac angiography showed an avascular area in the same area. Splenectomy was performed after choledocholithotomy and a pseudocyst was then diagnosed histologically. 従来, 脾嚢胞は比較的まれな疾患であつたが, 近年の画像診断の進歩により報告例が漸増している. 今回, われわれは総胆管結石に合併した脾仮性嚢胞の1例を経験したので, 若干の文献的考察を加えて報告する.症例は74才の女性, 1975年に他院で胆嚢結石のため胆嚢摘出術を受けている. 1987年, 上腹部痛が出現したため当院に入院した. 術前検査で総胆管に結石があり, CTにて脾は著明に腫大し, 上極から外側の被膜下にIow density areaを認めた. 腹腔動脈造影では無血管野を呈した. 総胆管結石摘出後に摘脾を行い, 組織学的に仮性嚢胞と診断された.