Laparoscopic total splenectomy for symptomatic congenital splenic cyst
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2024.216280Keywords:
Splenic diseases, Splenectomy, Cysts, Laparoscopy, Incidental findingsAbstract
Congenital splenic cysts are rare entities in surgical practice and a non-negligible percentage are asymptomatic. They present a wide differential diagnosis and diverse ways of manifesting themselves, making them a pathology that is difficult to diagnose. We present the unusual clinical case of a patient with a symptomatic congenital splenic cyst measuring 10 cm in diameter, with a peculiar location at the level of the hilum and lower pole of the spleen, who underwent a laparoscopic approach for resolution. The pathological study showed a cystic formation covered by a layer of squamous epithelium, with splenic parenchyma within normal histological limits. The diagnosis of congenital splenic cysts is most often made incidentally on an imaging study, most frequently in children and young adults. Clinically, when the cysts are large, due to the compression they exert on neighboring organs or due to distention of the capsule, they usually
cause symptoms. In the case of our patient, the symptoms reported were abdominal pain in the left upper quadrant, infrascapular and left lumbar region. The computed axial tomography
revealed the large size of the splenic cyst and the compression it exerted on the kidney. There
are several treatment modalities for splenic cysts that can range from: conservative treatment,
percutaneous drainage, marsupialization, partial splenectomy, and even laparoscopic or open total splenectomy. Currently, the trend in surgical treatment is to perform a partial splenectomy to guarantee immune function, but if the cyst is closely related to the splenic hilum, total splenectomy is the treatment of choice to avoid serious complications.
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Copyright (c) 2024 German Brito Sosa, Luis Enrique Andrade-Rojas, Ana Maria Iraizoz-Barrios
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