A rare splenic pseudocyst

Abstract

Pseudocysts of the spleen are very rare, found in <1% of the splenectomies done and usually develop secondary to trauma. Pseudocysts of spleen rarely grow to large size and most of these remain asymptomatic, they require exploration only in symptomatic cases and chances for spleen preservation in these cases are usually less. Here, we present two cases of this rare entity developing secondary to abdominal trauma in the past, both presented with complaints of pain and lump in the abdomen. After thorough investigations, laparotomy was done preserving spleen in one case and doing splenectomy in the other. On histopathological examination, diagnosis of splenic pseudocysts was confirmed by the absence of lining epithelium. We would like to report these two cases because of their rarity and as diagnostic dilemmas.

A Rare Encounter with an Expanding Pseudocyst of the Spleen

“…Splenic cysts have been a matter of curiosity, with a reported incidence of only around 800 globally [ 1 , 5 – 7 ]. Since their recognition in 1829 by Andral and first splenectomy in 1867 by Pean for this condition, there have been infrequent reports in the literature [ 8 ].…”

“…In symptomatic 2/3rds, symptoms include left hypochondrial pain radiating to the left shoulder or chest [ 5 , 8 , 16 ]. Other symptoms include early satiety, vomiting, dysphagia, and infrequently ipsilateral atelectasis and lower lobe pneumonia depending upon the location and organ of compression [ 1 , 17 ].…”

“…Symptoms also depend on the size of the SP which forms the basis for operative treatment and predicting complications. While SP larger than 5 cm usually dictates operative management, the risk of complications, like sudden increase in size due to intracystic bleed, secondary infections, and even fatality due to spontaneous intraperitoneal rupture, has been noted in larger SP [ 1 , 5 , 18 ]. SP may sometimes attain great dimensions with those exceeding 15 cm entitled giant pseudocysts [ 4 , 11 , 19 , 20 ].…”

Non-traumatic pseudocyst of spleen presenting as chronic abdominal pain and vomiting

“…Pseudocysts are cysts without a lining epithelium. They are quite uncommon in routine clinical practice1 and should be differentiated from more common lesions such as hydatid cysts, abscess of the spleen, etc. Various theories have been proposed for the aetiological basis of splenic pseudocysts, the most accepted being long-standing splenic haematomas that have turned into pseudocysts 2.…”

Unusual pseudocyst in a wandering spleen

“…It is generally asymptomatic, rarely presenting clinically due to mass effect or torsion 1. Pseudocysts of the spleen are rare lesions without a true epithelium layer 2. A pseudocyst presenting in a wandering spleen is an extremely rare event; to our knowledge, only two such cases have been previously described 3 4.…”