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INTERNATIONAL JOURNAL OF CLINICAL INVESTIGATION AND CASE REPORTS - Volume 2, Issue 1, (Jan-Mar)

Pages: 8-12
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Non-Traumatic Pseudocyst of Spleen Presenting as Chronic Abdominal Pain: Case Report

Author: Hina Khalid *, Naveed Ali Khan, Abdul Khalique Mahar, Munira Abdul Aziz

Category: Surgery

Abstract:

Introduction: Splenic pseudo cysts are extremely uncommon. Most of these cysts are asymptomatic and may result from previous blunt abdominal trauma. We report an interesting uncommon case of a large splenic pseudo cyst without a history of previous abdominal trauma.

Case Presentation: 44 years old female with normal BMI, married, non-smoker, non-alcoholic, and housewife. She had no past medical or surgical history and was not on any oral medications. She presented with upper abdominal pain and discomfort for 6 months. Irregular pain with mild intensity associated with shortness of breath, her physical examination was unremarkable. The abdominal ultrasound and contrast-enchased CT showed a large splenic cyst occupying the lower pole of the spleen, Echinococcus multilocularis antibody test was negative (Titer <1:16), Thus the Echinococcosis was excluded from the differential diagnosis. The differential diagnosis, in this case, was a non-parasitic splenic cyst. The patient underwent elective diagnostic laparoscopic with laparoscopic splenectomy.

Discussion: The patient had an uneventful postoperative recovery course. He was discharged from the hospital on the third postoperative day (within the expected time frame), and instructed to avoid heavy lifting for a few months and to complete the post-splenectomy vaccination protocol.

Conclusion: Pseudocyst of the spleen is quite uncommon in routine clinical practice and should be differentiated from more common lesions such as hydatid cysts, abscess of the spleen, etc. The Pseudocyst of the spleen is usually asymptomatic and is detected incidentally during the abdominal scan for other reasons. Splenectomy is the gold standard treatment for splenic pseudocysts. Partial splenectomy is the recommended procedure if at least 25% of splenic parenchyma is achievable.

Keywords: Splenic Pseudocyst , Non-Parasitic Splenic Cyst , Splenectomy

DOI: 10.55828/ijcicr-21-03

DOI URL: http://dx.doi.org/10.55828/ijcicr-21-03

References:

  1. Robbins FG, Yellin AE, Lingua RW, Craig JR, Turrill FL, Mikkelsen WP. Splenic epidermoid cysts. Ann Surg. 1978;187(2):231-235.
  2. Gibeily GJ, Eisenberg BL. Splenic pseudocysts - diagnosis and management. West J Med. 1988;148(4):464-466.
  3. Verma A, Yadav A, Sharma S, et al. A rare splenic pseudocyst. J Surg Case Rep. 2013;9:rjt086.
  4. Roberson F. Solitary cysts of the spleen. Ann Surg. 1940;111(5):848-850.
  5. Altintoprak F, Dikicier E, Kivilcim T, Ergonenc T, Dilek ON. An uncommon clinical entity, although common theoretically: pseudocyst of spleen - two case reports and review of the literature. Eur J Gen Med. 2012;9(1):64-68.
  6. Geraghty M, Khan IZ, Conlon KC. Large primary splenic cyst: a laparoscopic technique. J Minim Access Surg. 2009;5(1):14-16.
  7. Kostka R, Vernerova Z. Post-traumatic pseudocyst of the spleen. Rozhl Chir. 2010;89(9):464-468.
  8. Erlich P, Jameison CG. Nonparasitic splenic cyst: a case report and review. Can J Surg. 1990;33(4):306-308.
  9. Sinha PS, Stoker TA, Asaton NO. Traumatic pseudocyst of the spleen. J R Soc Med. 1999;92(9):450-452.
  10. Franchi T, Agha RA, Sohrabi C. Guideline: Updating Consensus Surgical Case Report (SCARE) Guidelines. Int J Surg. 2020;84:226-230.
  11. Fowler RH. Nonparasitic benign cystic tumors of the spleen. Int Abstr Surg. 1953;96:209-227.
  12. Martin JW. Congenital splenic cysts. Am J Surg. 1958;96(2):302-308.
  13. Ingle SB, Hinge CR, Patrike S. Epithelial cysts of the spleen: A mini review. World J Gastroenterol. 2014;20(38):13899-13903.
  14. Zinner MJ, Schwartz SI, Ellis H. Maingot's abdominal operations. J Am College Surg. 1997;3(185):307.
  15. Geraghty M, Khan IZ, Conlon KC. Large primary splenic cyst: a laparoscopic technique. J Minim Access Surg. 2009;5(1):14-16.
  16. Labruzzo C, Haritopoulos KN, Tayar AR, Hakim NS. Posttraumatic cyst of the spleen: a case report and review of the literature. Int Surg. 2002;87:152-156.
  17. S.M. Balzan, C.E. Riedner, L.M. Santos, C.M. Pazzinatto, P.R. Fontes. Post traumatic splenic cysts and partial splenectomy: report of a case. Surg Today. 2001;262-265
  18. Cissé M, Konaté I, Ka O, Dieng M, Dia A, Touré CT. Giant splenic pseudocyst, a rare etiology of abdominal tumor: a case report. Cases J. 2010;3(1):1-2.
  19. Sarmast AH, Showkat HI, Parray FQ, Lone R. Non-parasitic splenic cyst: a case report. Acta Med Iran. 2012;50(12):849-851.
  20. Williams RJ, Glazer G. Splenic cysts: changes in diagnosis, treatment and aetiological concepts. Ann R Coll Surg Engl. 1993;75(2):87-89.
  21. Robertson F, Leander P, Ekberg O. Radiology of the spleen. Eur Radiol. 2001;11(1):80-95.
  22. Sierra R, Brunner C, Murphy JT, Dunne JB, Scott DJ. Laparoscopic marsupialization of a giant posttraumatic splenic cyst. J Soc Laparoendoscopic Surg. 2004;8(4):384-388.
  23. Kundal VK, Gajdhar M, Kundal R, Sharma C, Agarwal D, Meena A. Giant epithelial non-parasitic splenic cyst. J Case Rep. 2013;3(2):106-109.
  24. Eraklis AJ, Kevy SV, Diamond LK, Gross RE. Hazard of overwhelming infection after splenectomy in children. N Engl J Med. 1967;276(22):1225-1229.
  25. Schier F, Waag KL, Ure B. Laparoscopic unroofing of splenic cysts results in a high rate of recurrences. J Pediatr Surg. 2007;42(11):1860-1863.
  26. Ravera M, Cocozza E. Post-traumatic pseudocyst of the spleen: case report on a conservative management through percutaneous management. G Chir. 1999;20(11-12):471-473.
  27. Moir C, Guttman F, Jequier S, Sonnino R, Youssef S. Splenic cysts: aspiration, sclerosis, or resection. J Pediatr Surg. 1989;24(6):646-648.
  28. Kundal VK, Gajdhar M, Kundal R, Sharma C, Agarwal D, Meena A. Giant epithelial non-parasitic splenic cyst. J Case Rep. 2013;3:106-109.
  29. Abd EM. Giant splenic cyst with hypersplenism: laparoscopic splenectomy. J Gastroenterol Hepatol. 2013;2:549-551.
  30. Aggarwal, Ramesh Kumar; Mohanty, Bishal Badal; Prasad, Arun. Laparoscopic splenic pseudocyst management using indocyanine green dye: An adjunct tool for better surgical outcome. J Minimal Access Surg. 2019;15(2):154-157.