Complicated congenital splenic cyst: Saved by a splenunculus

Abstract

A 12-year-old girl presented with a large congenital splenic cyst complicated by Salmonella organisms. After failure of conservative management and percutaneous drainage, a splenectomy was performed. An incidental splenunculus was preserved. On follow up the splenunculus had increased to normal splenic size and there was no evidence of Howell-Jolly bodies, suggesting normal splenic function.

Huge Non-parasitic Mesothelial Splenic Cyst in a Child: A Case Report and Literature Review

“… 1 On the other hand, females were found to be more affected by splenic cyst in general and congenital type in particular. 22 , 23 …”

Case report of successful partial splenectomy for a splenic abscess in a paediatric patient

“…The common organisms cultured from splenic abscess include Staphylococci, Streptococci, Salmonella and Escherichia coli although most of the microbiological data are from adult studies [9] . Salmonella has been isolated in 11–15% of splenic abscesses and has also been implicated as the causative organism in the immunocompetent child [2] , [3] , [10] . Salmonella is the most commonly identified cause of foodborne illness in U.S and most cases involve ingestion of contaminated food item [11] .…”

“…Total splenectomy puts patients at risk of rare but life threatening overwhelming post-splenectomy sepsis. Percutaneous drainage is mostly a temporizing measure before interval surgery and is often complicated by recurrence of collections or incompletely emptied cavities, although some authors have reported good outcomes [1] , [2] , [3] , [16] . Choudhury et al reported a case series of 18 patients with isolated SA who were successfully managed with antibiotics and image-guided percutaneous drainage with all patients having complete resolution [16] .…”

“…They are seen in patients with an immunocompromised state, however can also occur in the immunocompetent due to dissemination of an infective focus to a pre-existing splenic cyst. The management options for SA has shifted from total splenectomy to spleen-preserving techniques whenever possible, such as percutaneous drainage, partial splenectomy and subtotal splenectomy, due to greater understanding of the important immunologic role of the spleen [1] , [2] , [3] , [4] , [5] .…”

Laparoscopic partial splenectomy for congenital splenic cyst in a pediatric patient: Case report and review of literature

“…NPSC are classified based on the presence (congenital) or absence (post-traumatic) of epithelial lining [3]. Management of a non-parasitic splenic cyst is controversial: cystectomy, fenestration, percutaneous drainage and sclerotherapy, partial or total splenectomies have all been described [5], [6], [7], [8]; some authors conclude that splenic tissue preservation is recommended to avoid the overwhelming post-splenectomy infection (OPSI) [9]. Here in, we present our management of a splenic congenital cyst in a pediatric patient.…”