Post-traumatic Pseudocyst of the Spleen

Česká verzia

Authors: R. Kostka; Z. Vernerová ^*
Authors place of work: Chirurgická klinika 3. LF UK a FNKV, Praha 10, přednosta: prof. MUDr. R. Gürlich, CSc. ; Ústav patologie 3. LF UK a FNKV, Praha 10, přednosta: prof. MUDr. V. Mandys, CSc. ^*
Published in the journal: Rozhl. Chir., 2010, roč. 89, č. 9, s. 564-568.
Category: Monothematic special - Original

Summary

Introduction:
Post-traumatic splenic pseudocysts are rare condition and comprise more than 75 % of non-parasitic cysts. They result from subcapsular or intraparenchymatous hematoma, by its liquefaction and creation of the fibrous peripheral capsula. Splenic pseudocysts have no epithelial lining, its diameter could be more than 15 cm and are mostly symptomatic.

Case report:
A female, 53 years old, was admitted to the Clinic of surgery with blunt pains in the left hypochondrium after falling on the left side of body 6 months ago. Ultrasonography and CT scan reveal posttraumatic pseudocyst of the spleen, 156 x 135 x 148 mm in diameter. The splenic parenchyma was reduced to 15 mm dorso-caudal. Extirpation of the pseudocyst and splenectomy during laparotomy was performed with healing per primam. The patient was discharged 6 day after surgery.

Conclusion:
Posttraumatic splenic pseudocysts are good diagnosed in CT scan. Giant pseudocysts and psuedocysts in splenic hilus require surgical resection. Spleen parenchyma preserving operations, currently recommended in small cysts, reduce the risk of early and late septic complications, particularly overwhelming postsplenectomy sepsis. Partial splenectomy offers a definitive treatment of a splenic cyst while preserving splenic functions. Miniinvasive surgery as a percutaneous drainage and laparoscopic fenestration have an unacceptably high rate of failure.

Key words:
splenic pseudocyst – splenectomy

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