Villalobos REJ, Sánchez JGO, Vega JM

Language: Spanish
References: 23
Page: 43-49
PDF size: 426.95 Kb.

ABSTRACT

Introduction: There are 800 cases reported in the literature. More frequent in the second and third decades of life. The cysts are classified into true: parasitic and non-parasitic (dermoid, epidermoid, and neoplastic epithelial); and pseudocyst, secondary to trauma. They are asymptomatic, 40% are presented like this. Greater than 5 cm have risk of rupture, infection, hemorrhage; surgical treatment becomes necessary. Objectives: Review of the literature on therapeutic options. Case report: Female 18 years old, a year with abdominal pain, denied other symptoms. Came to the emergency for exacerbation of pain and increased volume. On examination with pallor, abdomen with increased volume in the left upper quadrant, matte percussion, splenomegaly up to umbilicus, without peritoneal irritation. Platelet 100, Echinococcus serology negative. CT: 18 x 15 cm giant splenic cyst. Diagnosis: giant splenic cyst, pancytopenia. Preoperative preparation: pneumococcal vaccination and Haemophilus, cover with ceftriaxone. Exploraty laparoscopy: supine position, 4 trocars. Puncture and drain cyst with splenectomy was performed. Findings: cyst in the upper pole, surrounded by parenchyma, 3 liters of sallow content, bleeding 800 mL. Pathology report-epidermal cyst 17 cm. Conclusions: The goals should be to prevent complications, prevent and control the cyst recurrence. Several therapeutic options: percutaneous drainage, marsupialization, fenestration, partial and total splenectomy.

REFERENCES

1. Strambu IC, Popa F, Puscu C, Radu P. Congenital splenic cyst, case study. Journal of Medicine and Life. 2011; 4: 102-104.

2. Adas G, Karatepe O, Altiok M, Battal M, Bender O, Ozcan D et al. Diagnostic problems with parasitic and non-parasitic splenic cysts. BMC Surg. 2009; 9: 9.

3. Radakovich M. Epidermoid cyst of the spleen. Ann of Surg. 1949; 131: 268-276.

4. Robbins FG, Yellin AE, Lingua RW, Craig JR, Turril FD, Mikkelsen WP. Splenic epidermoid cysts. Ann of Surg. 1978; 187: 231-235.

5. Hong A, Choi N, Sun K, Lim Sh, Han Y. Epidermoid cyst arising from an intrapancreatic accessory spleen: a case report and review of the literature. Oncology Letters. 2013; 5: 469-472.

6. Thomas M, Taiwo B. Splenic epidermoid cysts presenting as an acute abdomen. Postgrad Med J. 1994; 70: 376-377.

7. Choi KS, Ik Ahn S, Hong KCh, Joong KS, Sook KT, Hong WZ et al. A case of epdermoid cyst of the intrapancreatic accessory spleen. J Korean Med Sci. 2000; 15: 589-592.

8. Chin EH, Shapiro R, Hazzan D, Katz LB, Salky B. A ten-year experience with laparoscopic treatment of splenic cysts. JSLS. 2007; 11: 20-23.

9. Uludag M, Yetkin G, Citgez B, Karakoc S, Polat N, Yener S. Giant true cyst of the spleen with elevated serum markers, carbohydrate antigen 19-9 and cancer antigen 125. BMJ Case Rep. 2009; Article locator: bcr03.2009.1691.

10. Park AE, Godinez CD. Chapter 34. Spleen. In: Brunicardi FC. Schwartz’s principles of surgery. 9th ed. McGraw Hill; pp. 1245-1266.

11. Daga G, Mittal V, Singh RJ, Sood N. Epithelial cyst of the spleen. J Indian Assoc Pediatr Surg. 2011; 16: 18-20.

12. Caremani M, Occhini U, Caremani A, Tacconi D, Lapini L, Accorsi A et al. Focal splenic lesions: US findings. J Ultrasound. 2013; 16: 65-74.

13. Karfis EA, Karfis EA, Roustanis E, Tsimoyiannis EC. Surgical management of nonparasitic splenic cysts. JSLS. 2009; 13: 207-212.

14. Martin JW. Congenital splenic cysts. Am J Surg. 1958; 96: 302-308.

15. Hansen MB, Moller AC. Splenic cysts. Surg Laparosc Endosc Percutan Tech. 2004; 14: 316-322.

16. Geraghty M. Large primary splenic cyst: a laparoscopic technique. J Minim Access Surg. 2009; 5: 14-16.

17. Marohn MR. Minimally invasive surgical approache to the spleen. Chapter 133. In: Charles JY. Shackelford’s surgery of the alimentary tract. 7th ed. Elsevier Saunders; 2013.

18. Geraghty M, Khan IZ, Conlon KC. Large primary splenic cyst: a laparoscopic technique. J Minim Access Surg. 2009; 5: 14-16.

19. Comitalo JB. Laparoscopic treatment of splenic cysts. JSLS. 2001; 5: 313-316.

20. Pitiakoudis M, Zezos P, Oikonomou A, Laftsidis P, Kouklakis G, Simopoulos C. Total splenectomy due to an unexpected “complication” after successful extended laparoscopic partial decapsulation of a giant epidermoid splenic cyst: a case report. Case Reports in Medicine. 2011; article ID 318208. pp. 7.

21. Pattenden CJ. Laparoscopic splenectomy: a personal series of 140 consecutive cases. Ann R Coll Surg Engl. 2010; 92: 398-402.

22. Thomas MS. Cysts and tumors of the spleen. Chapter 136. In: Charles JY. Shackelford’s surgery of the alimentary tract. 7th ed. Elsevier Saunders; 2013.

23. Tavakkoli A. The spleen. Chapter 62. In: Zinner MJ, Ashley SW. Maingot’s abdominal operations. 12th ed. McGraw Hill; 2013.