A Case of Splenic Pseudocyst Difficult to Differentiate from Splenic Lymphangioma / 대한소화기학회지

Splenic pseudocyst is a rare complication of abdominal trauma. Although it is rare, splenic pseudocyst is well-documented in the literature. According to the current classification, approximately 30% of all splenic cysts or pseudocysts result from direct abdominal trauma. In addition, chronic pancreatitis leads to change of nearby organs with possible acute and chronic complications including splenic lesions. This unusual complication can occur in both emergent and nonemergent conditions. The useful diagnostic procedures to assess intrasplenic pseudocyst are sonogram, CT scan, splenic scan, and occasionally angiography. However, definite diagnosis of pseudocyst is possible only after splenectomy when the absence of epithelial lining is confirmed histologically. Splenic pseudocyst requires surgical resection. We experienced a 31-year-old man who confirmed of warmness in the left side of back with left upper quadrant abdominal pain for several months. First impression was splenic lymphangioma based on CT scan and sonogram finding. Splenectomy was performed. Microscopic examination revealed splenic pseudocyst with fibrous capsule without epithelial lining.

Laparoscopic Partial Splenectomy for Splenic Pseudocyst

Splenic preservation and conservative management are now accepted norms when dealing with splenic pathologic conditions. Recently, we managed one case of splenic pseudocyst by successfully performing partial splenectomy via a laparoscopic approach. This case report possibly the first case report of its kind in Korea, describes laparoscopic partial splenectomy for an undiagnosed and suspected benign splenic lesion. A thorough understanding of splenic anatomy permits laparoscopic partial splenectomy with the resultant benefits, including a decreased risk of postsplenectomy sepsis by preserving splenic function, short hospital stay, smooth convalescence, superior cosmesis, and non-recurrence. The success and relative ease of performing this procedure will pave the way for its future use in other selective cases involving splenic pathology.

Laparoscopic Management of Splenic Pseudocyst

Splenic cysts are rare entities. They are either true cysts or pseudocysts. Former is thought to be congenital or parasitic while the latter are considered post-traumatic. Developments in imaging and operative surgery have led to significant changes in the management of these cysts. We present a case of young male with a large splenic pseudocyst who was managed successfully by minimally invasive surgical approach. Pertinent literature is reviewed briefly.