PDF(Pubmed)
Abstract：
BACKGROUND: A chronic expanding hematoma is an uncommon entity described as an organized blood collection that increases in size after the initial hemorrhagic event without histological neoplastic features. The standard treatment is complete resection. To our knowledge, this is the first report of a chronic expanding hematoma mimicking a pancreatic cystic tumor that has been successfully resected utilizing a laparoscopic approach.
METHODS: We report the case of a 32-year-old man with a 10-cm chronic expanding hematoma that was preoperatively diagnosed as a cystic pancreatic tumor. Dynamic computed tomography revealed a cyst at the inferior part of the uncinate process of the pancreas without contrast enhancement. His blood biochemical data were within normal limits. The operation initially utilized a laparoscopic approach; however, the procedure was converted to hand-assisted laparoscopic surgery due to capsule adherence to surrounding organs and finally, enucleation of the tumor was performed. Pathological findings revealed a chronic expanding hematoma in the retroperitoneal space.
CONCLUSIONS: Chronic expanding hematoma in the retroperitoneal space is so rare and sometimes adheres to the surrounding tissue. It is difficult to distinguish hematoma attaching pancreas and pancreatic cyst preoperatively. In rare cases such as this, hand-assisted laparoscopic surgery is a feasible, less invasive procedure for facilitating complete resection and preventing recurrence.
METHODS: We report the case of a 32-year-old man with a 10-cm chronic expanding hematoma that was preoperatively diagnosed as a cystic pancreatic tumor. Dynamic computed tomography revealed a cyst at the inferior part of the uncinate process of the pancreas without contrast enhancement. His blood biochemical data were within normal limits. The operation initially utilized a laparoscopic approach; however, the procedure was converted to hand-assisted laparoscopic surgery due to capsule adherence to surrounding organs and finally, enucleation of the tumor was performed. Pathological findings revealed a chronic expanding hematoma in the retroperitoneal space.
CONCLUSIONS: Chronic expanding hematoma in the retroperitoneal space is so rare and sometimes adheres to the surrounding tissue. It is difficult to distinguish hematoma attaching pancreas and pancreatic cyst preoperatively. In rare cases such as this, hand-assisted laparoscopic surgery is a feasible, less invasive procedure for facilitating complete resection and preventing recurrence.
摘要：
背景：慢性扩大血肿是一种罕见的实体，被描述为有组织的血液收集，在最初的出血事件后大小增加，没有组织学肿瘤特征。标准治疗是完全切除。据我们所知,这是首次报道模仿胰腺囊性肿瘤的慢性扩大血肿，该血肿已通过腹腔镜手术成功切除。
方法：我们报告了一例32岁男性患有10厘米慢性扩大血肿，术前诊断为囊性胰腺肿瘤。动态计算机断层扫描显示胰腺钩突下部有囊肿，无对比增强。他的血液生化数据在正常范围内。手术最初采用腹腔镜方法；然而，由于胶囊与周围器官的粘附，该程序被转换为手助腹腔镜手术，最后，进行肿瘤摘除。病理结果显示腹膜后间隙有慢性扩大性血肿。
结论：腹膜后间隙的慢性扩大血肿非常罕见，有时会粘附于周围组织。术前难以区分合并胰腺的血肿和胰腺囊肿。在这种罕见的情况下，手助腹腔镜手术是可行的,有助于完全切除和防止复发的微创手术。
方法：我们报告了一例32岁男性患有10厘米慢性扩大血肿，术前诊断为囊性胰腺肿瘤。动态计算机断层扫描显示胰腺钩突下部有囊肿，无对比增强。他的血液生化数据在正常范围内。手术最初采用腹腔镜方法；然而，由于胶囊与周围器官的粘附，该程序被转换为手助腹腔镜手术，最后，进行肿瘤摘除。病理结果显示腹膜后间隙有慢性扩大性血肿。
结论：腹膜后间隙的慢性扩大血肿非常罕见，有时会粘附于周围组织。术前难以区分合并胰腺的血肿和胰腺囊肿。在这种罕见的情况下，手助腹腔镜手术是可行的,有助于完全切除和防止复发的微创手术。
