连续型脾性腺融合1例报道及文献复习

Continuous splenogonadal fusion:a case report and review of literature

患儿,男,4岁,因左侧阴囊出现无痛性团块3年收治入院。查体左侧腹股沟至阴囊依次可及3个类似睾丸样团块,上方及中部质地稍硬,下方质地稍软。入院后腹腔镜探查发现左侧有脾性腺融合(splenogonadal fusion,SGF),行保留左侧睾丸副脾切除术。术后随访18个月,睾丸发育良好、无萎缩,腹部B超提示肝、胆、脾未见异常。SGF是少见的先天异常,术前诊断困难,术中发现SGF应采取保留睾丸副脾切除术。腹腔镜技术可作为一个有效的诊治方法,其可提高对SGF的认识,避免不必要的睾丸切除术。

A 4-year-old boy with a painless mass for 3 years in the left scrotum was admitted to the hospital.Three testicle-like substances could be palpable one by one from groin to scrotum on the left side during physical examination.The upper and middle parts were slightly hard,while the lower part was slightly soft.The splenogonadal fusion(SGF)in the left side was found by laparoscopy after admission.Accessory splenectomy was performed with preservation of the left testicle.Postoperative follow-up was 18 months.The testicles were well developed without atrophy,and abdominal B-ultrasound showed no abnormality in liver,gallbladder and spleen.SGF was a rare congenital abnormality,which was difficult to diagnose preoperatively.During the operation,if the SGF was found,accessory splenectomy with testicle-sparing should be performed.Laparoscope can be used as an effective diagnosis and treatment method to improve the understanding of SGF,and avoid unnecessary orchiectomy.