Oversized pseudocysts of the spleen: Report of two cases

Abstract

INTRODUCTIONPseudocysts of the spleen are usually asymptomatic and associated with a history of trauma, infection or infarction. In this report, we present two uncommon cases of solitary, oversized pseudocysts of the spleen.PRESENTATION OF CASETwo patients (cases A and B), with symptoms of abdominal pain, were investigated. The laboratory and ultrasound examination confirmed the diagnosis of a large, non-parasitic splenic cyst in both cases. Computed tomography described an oversized pseudocyst occupying almost the entire splenic parenchyma in both cases and in patient A, the cyst was located in the splenic hilum. The medical history revealed a previous abdominal injury only in case A. The two patients underwent an open total splenectomy. The pathology examination verified the diagnosis of a non-parasitic splenic pseudocyst.DISCUSSIONBoth patients presented with symptoms, in contrast to the majority of patients with splenic cysts. The medical history of patients with splenic pseudocysts does not always reveal the cause of the pseudocyst formation. Any type of spleen-sparing procedure is not easy to perform in cases of surgical and anatomical difficulty, because of recurrence and the risk of intractable bleeding from the spleen.CONCLUSIONPartial splenectomy is the recommended method for parenchymal preservation, but total splenectomy is preferred when the splenic cyst is oversized or cannot be excised with safety.

Sclerotherapy using polidocanol foam for a giant splenic cyst

“…Treatment indications for splenic cysts include a large size (usually >4 cm), symptoms (eg, pain, early satiety, or hydronephrosis) [ 7] , and pregnancy due to the risk of rupture [8] . Besides, an adequate diagnosis is also important [9] .…”

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

“…Most of the symptoms are related to the size of the cyst which can include diffuse abdominal pain, fullness in the left abdomen, nausea, vomiting, flatulence and diarrhea, thrombocytopenia, complications such as infection, rupture and/or hemorrhage [1] , [15] .…”

A Rare Encounter with an Expanding Pseudocyst of the Spleen

“…Etiologically, SP represents a resolved hematoma in the parenchymal or subcapsular location due to a preceeding blunt injury [ 1 , 2 , 4 ]. Suggested alternate etiologies include infections and degenerative diseases [ 4 , 21 ].…”

“…Cysts in the spleen are uncommon, and amongst these one rare kind is SP [ 1 , 2 ]. Previous blunt abdominal trauma is implicated in at least 75% of cases [ 1 , 3 ].…”