Spleen preserving management of a non-parasitic splenic cyst in pregnancy

Laparoscopic organ-sparing surgery for cystic lesions of the spleen – own observations

<b>Introduction:</b> Splenic cysts are quite rare. In this publication, authors focus on presenting their own observations related to the management of patients with such lesions. </br></br> <b> Aim:</b> To evaluate the effectiveness of laparoscopic procedures in the case of patients with splenic cysts. </br></br> <b>Material and methods:</b> The study included patients treated surgically for cystic lesions located in the spleen at the 2^nd Department of General, Gastroenterological and Oncological Surgery of the Medical University of Bialystok over the years 2017–01.2020. </br></br> <b>Results:</b> All patients were referred for elective excision of the spleen lesion (the size of the lesions ranged from 7 to 15 cm – based on CT examination). In all cases, excision of the anterior wall of the cyst was performed with the help of advanced surgical tools. The duration of the procedure ranged between 65 and 100 minutes. No significant blood loss was observed. No postoperative complications were found. </br></br> <b>Conclusions:</b> In conclusion, sparing laparoscopic surgery for cystic lesions of the spleen seem to be safe and rarely associated with complications or relapses. Extending the scope of the procedure to total splenectomy should also not pose a major problem.

Giant splenic cyst with expectant management in pregnancy: A case report and review of the literature

A 22-year-old primigravida was diagnosed with an 18-cm splenic cyst during routine third-trimester routine ultrasound examination. She was referred to a tertiary obstetric hospital and after multidisciplinary consultation, expectant management was decided on. Induction of labour was performed at term and she delivered vaginally with vacuum extractor application without complications. Percutaneous aspiration and sclerotherapy of the cyst was performed one week after delivery. She was hemodynamically stable throughout.

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The diagnosis of large splenic cyst during pregnancy is a rare event and management is not standardized.

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Different managements have been reported, but no strong evidence was found to support the superiority of any single treatment.

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We report a case of a hemodynamically stable woman diagnosed with a large splenic cyst in the third trimester.

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Expectant management was decided on, induction of labour was performed at term and the patient delivered vaginally.

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Pregnant women diagnosed with a splenic cyst should be managed by a multidisciplinary team.

Massive splenic cyst in pregnancy: case report

BACKGROUND

Primary splenic cysts are very rarely diagnosed in pregnancy, with only thirteen cases described in the literature. We examine the approach towards diagnosing and managing uniquely large abdominal masses that significantly complicate obstetric care.

CASE PRESENTATION

A 37-year-old primigravida woman presented with abdominal distension and discomfort, yet otherwise asymptomatic. On ultrasound, an incidental pregnancy at 25 weeks of gestation and a large pelvic lesion were discovered. MRI defined a 28 × 29 cm lobulated, complex cystic mass in the upper abdomen. The patient underwent two ascitic drainages throughout her pregnancy. At 34 weeks of gestation, she had a classical caesarean section. Then at five-weeks postpartum, she underwent a laparotomy and total splenectomy with 16 L of fluid drained. Histopathological analysis revealed an epithelial cyst of the spleen. Her recovery was complicated by complete portal vein thrombosis.

CONCLUSION

This case describes the largest splenic cyst ever reported in pregnancy and explores the diagnostic dilemmas and treatment challenges associated. We introduce the utility of serial ascitic drainages in prolonging the pregnancy and emphasise the reliance on imaging for surveillance of splenic size and fetal wellbeing.

A Case of Small Intestinal Ileus Due to Wandering Spleen with a Large Cyst

Patient: Female, 28

Final Diagnosis: Ileus due to wandering spleen with a cyst

Symptoms: Acute abdominal pain

Medication: —

Clinical Procedure: Tube decompression • laparotomy

Specialty: Abdominal Surgery • Transplant Surgery

Primary splenic pregnancy with hemorrhagic shock

Primary splenic pregnancy, a type of abdominal pregnancy, is very rare and potentially life-threatening, particularly without an accurate preoperative diagnosis. Herein we describe the case of a 27-year-old woman who had primary splenic pregnancy with hemorrhagic shock due to spleen rupture, who was successfully treated by laparotomy.

[Laparoscopic cleavage in splenic symptomatic cyst]

BACKGROUND

Splenic cysts are rare diseases that are diagnosed incidentally during imaging studies. When cysts are recognized, surgical treatment is recommended adapted to the particular case, depending on the size and location of the cyst and the age of the patient in order to avoid dangerous complications such as spleen rupture or cyst infection with abscess.

CLINICAL CASE

We report 2patients with symptomatic splenic epidermoid cyst treated by laparoscopic cleavage.

CONCLUSIONS

Laparoscopic cleavage is a surgical option for splenic cyst, with the goal of reducing postoperative complications while preserving splenic function.