迟发性脾破裂误诊为急性冠脉综合征一例并文献复习

A Case Analysis of Misdiagnosis of Delayed Rupture of Spleen as Acute Coronary Syndromes

迟发性脾破裂是脾脏受伤后脾被膜下出现血肿,或脾被膜下的裂口不大,出血缓慢,血液凝固或大网膜包裹裂口而暂时不出血,48 h后才出现腹腔内出血症状,其临床表现不典型,症状隐匿,诊断较为困难,误诊率高,使治疗延误。本文对1例迟发性脾破裂误诊为急性冠脉综合征患者的临床资料进行分析,探讨其误诊原因及对策。

Delayed rupture of the spleen referred to all kinds of spleen rupture when spleen being injuried,which presented as injured splenic subcapsular hematoma,or slow bleeding with a little gap under the spleen capsule,or not bleeding temporarily because of blood coagulation or the gap being wrapped by omental until 48 h later.Due to its untypical clinical manifestations,hidden symptoms,the diagnosis of delayed rupture of spleen was difficult or even turned out wrong,directly causing the treatment to be delayed.This paper analyzed one case of delayed splenic rupture being misdiagnosed as acute coronary syndrome and explored the reason of misdiagnosis as well as its countermeasures.