Giant complex non-parasitic splenic cyst in a young boy: is laparoscopic spleen-preserving surgery safe?

Non-parasitic splenic cysts are an uncommon finding in pediatric patients. We report on a 14-year-old male presenting with a giant abdominal mass. Imaging documented a giant splenic cyst, and preoperative blood tests revealed high levels of CA125. Minimally invasive unroofing of the cyst was performed. Notably, the cyst content was hematic, but histopathological studies described a mesothelial cyst lining. To date, no recurrence has been noted. Laparoscopic spleen-preserving surgery appears to be a valid and safe treatment option in children with complex non-parasitic splenic cyst to preserve the splenic parenchyma.

Laparoscopic spleen-preserving dome resection for a giant primary epithelial splenic cyst

Non-parasitic splenic cysts are rare and are seldom diagnosed outside the paediatric surgical practice. Giant true primary epithelial cysts greater than 14 cm in diameter are even rarer. Laparoscopic surgery is preferable; however, bleeding, splenectomy and recurrence are recognised risks. Here, we report a young female patient with a 21 cm symptomatic primary splenic cyst. The patient underwent a spleen-preserving laparoscopy and was followed up for 2 years when she had an MRI of the abdomen. Surgical, technical and perioperative treatment aspects are discussed here, in the context of the current literature.

Splenic cyst following trauma, the intraoperative decision on definitive management

Introduction. Posttraumatic splenic cysts are most commonly the result of blunt force trauma to the abdomen. They usually develop from subcapsular or intraparenchymal hematomas and these cysts are typically asymptomatic. Diagnostics includes clinical history and radiological imaging procedures. Surgical treatment is only curative modality of treatment. Case outline. A 43-year-old female patient, without comorbidities, was admitted to the health institution for additional diagnostics and surgical treatment. Laboratory test results were within the reference ranges while serological test results for hydatid disease were negative. An abdominal CT examination was subsequently performed confirming a splenic cyst positioned in the central part of the spleen. After a laparoscopic partial pericystectomy of the cyst, we identified another smaller cyst of the spleen. According to the estimation of the surgical team, the intraoperative appearance of the remaining tissue of the spleen was less than a third of the entire spleen. . The decision was taken to perform a splenectomy in the best interests of the patient, bearing in mind the possibility of complications Conclusion. Accurate diagnosis of posttraumatic splenic cysts remains a challenge, despite state-of-the-art radiological imaging procedures that are applied. In addition to the well-known modalities of treatment, the laparoscopic surgical approach, i.e., minimally invasive treatment, should be the one of choice, if the situation allows it. The laparoscopic approach is a diagnostic and therapeutic method whose effect can especially be observed when the intraoperative finding differs from the preoperative radiological finding.

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

Background: Splenic cysts are one of the relatively rare conditions in pediatric surgery practice. Primary non-parasitic splenic cysts are even more scarce. Case presentation: A 13-years-old female patient presented with chronic left hypochondrial pain of 2 months duration. Abdominal ultrasonography and computed tomography revealed huge 18 cm × 14 cm × 10 cm splenic cyst. Deroofing of the cyst was done which was complicated by secondary infection. Subsequently, the patient was re-operated on and partial splenectomy done with good outcome at 6 months follow up. Conclusion: Partial splenectomy is the best management strategy for huge non-parasitic splenic cysts in children. There is also less recurrence rate of splenic cysts with preservation of splenic functions.