Splenic cyst in a wandering spleen: laparoscopic treatment with preservation of splenic function

Falchetti, Diego; Torri, Fabio; Dughi, Sergio; Porto, Celeste; Manciana, Alessandro; Boroni, Giovanni; Ekema, George

doi:10.1016/j.jpedsurg.2007.03.063

Cited by 14 publications

(16 citation statements)

References 14 publications

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“…Within the patients who underwent splenopexy, three patients underwent splenopexy and gastropexy for gastric volvulus (two were performed by laparotomy and one by laparoscopy) [15-17]. Splenic cysts were noted in two cases thus requiring splenopexy and cystectomy, both performed as open procedures [18,19]. For patients that had viable spleens intraoperatively and underwent splenopexy, six had mesh placed to secure the spleen (four used vicryl mesh, one reported use of non-absorbable mesh, and one had polypropylene) [14,19-22].…”

Section: Discussionmentioning

confidence: 99%

“…Splenic cysts were noted in two cases thus requiring splenopexy and cystectomy, both performed as open procedures [18,19]. For patients that had viable spleens intraoperatively and underwent splenopexy, six had mesh placed to secure the spleen (four used vicryl mesh, one reported use of non-absorbable mesh, and one had polypropylene) [14,19-22]. The remainder of splenopexies used adjacent tissue from the diaphragm, anterior abdominal wall, or peritoneum to create pouches for the spleen.…”

Section: Discussionmentioning

confidence: 99%

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Non-operative management of a rare diagnosis of splenic torsion in a child with a history of giant omphalocele: a case report and literature review

et al. 2014

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BackgroundSplenic torsion is rare and as a result the appropriate management is unclear. While there has been a shift towards splenectomy and laparoscopic splenopexy, we present a successful case of non-operative management of splenic torsion in a patient with a history of a giant omphalocele.Case presentationA 3 year-old female presented with a three-day history of abdominal pain, fever and non-bloody emesis three and a half years after repair of her giant omphalocele. Abdominal radiographs and ultrasound demonstrated migration of the spleen and a subsequent computerized tomography scan confirmed splenic torsion and an infarcted spleen. Given her late presentation, she was successfully managed with observation, analgesia, immunization against capsulated organisms and daily penicillin prophylaxis with excellent outcome at 19 months follow-up. A review of the literature revealed that splenic torsion is rarely managed non-operatively. Rarer still is the occurrence of splenic torsion following a history of omphalocele.ConclusionAlthough rare, splenic torsion should be considered in a child with a history of omphalocele presenting with abdominal pain. Non-operative management of an infarcted spleen can be a safe treatment option to avoid surgery in complex patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Non-operative management of a rare diagnosis of splenic torsion in a child with a history of giant omphalocele: a case report and literature review

et al. 2014

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“…La chirurgie à ciel ouvert reste la plus utilisée [14], mais la laparoscopie a aussi été utilisée avec succès pour le kyste hydatique splénique [6]. Une alternative à la chirurgie est le drainage percutané et l'administration d'agents sclérosants tels que l'alcool à 96 % sous contrôle de l'échographie [15]. Les procédures chirurgicales conservatrices sont de plus en plus utilisées chez les enfants, incluant le drainage interne avec anastomose de la kystojéjunale ou le drainage externe.…”

Section: Discussionunclassified

Kyste hydatique primitif de la rate: deux cas. Peut-on être conservateurs ?

Bourazza

Zentar

Ali

et al. 2009

J Afr Hepato Gastroenterol

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Introduction : À travers deux observations de kystes hydatiques spléniques, nous discutons la prise en charge de cette pathologie rare. La sélection de la technique chirurgicale à ciel ouvert ou par laparoscopie devrait être choisie d'après la dimension du kyste et son emplacement.Observations : Le premier cas est un kyste hydatique de type 1, survenu chez une jeune patiente et qu'on a opéré par coelioscopie avec conservation splénique. Le second cas est un kyste remanié multicloisonné chez une patiente de 38 ans où une splénectomie a été nécessaire. Résultats : Dans les deux cas, l'évolution était satisfaisante, mais pour une hospitalisation plus longue pour la splénectomie : dix jours, alors que la durée d'hospitalisation pour l'attitude conservatrice est de cinq jours sans les contraintes immunitaires postsplénectomie. Conclusion : Le kyste de l'hydatique splénique devrait être traité chirurgicalement, dû au haut risque d'une rupture. La procédure la plus utilisée, chez l'adulte, est la splénectomie standard, mais la technique chirurgicale devrait être choisie d'après la dimension du kyste et son emplacement. À notre avis, la conservation splénique devrait être entreprise chaque fois que le kyste est unique et superficiel. Mots clés Kyste hydatique · Rate · CoelioscopieAbstract Introduction: Via two cases of hydatid cyst of the spleen, we discuss the management of this rare disease. The choice of open surgery or laparoscopy depends on the size of the cyst and its location. Cases: The first case was a hydatid cyst type 1 occurring in a young patient, which was operated by celioscopy with splenic conservation. The second case was a modified multilocular cyst in a patient aged 38 years, where a splenectomy was necessary.Results: In both cases, the evolution was satisfactory, except the splenectomy needed a ten-day hospitalization, whereas the length of hospitalization for the conservative approach was five days and did not require postsplenectomy immune care. Conclusion: Hydatid cyst of the spleen should be treated surgically because of the high-risk of rupture, the most widely used approach in adults is standard splenectomy but the surgical technique should be chosen according to the size of the cyst and its location. In our opinion splenic conservation should be implemented in all cases of single, superficial cysts.

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“…cause severe complications related to torsion or trauma (1,2), especially in the case of a pedunculated lesion. Although it is thought that pancreatic tumors seldom wander because they are usually nonpedunculated, a large and encapsulated pancreatic mass as in the present case would move due to good mobility.…”

Section: And Other Cases Include Ovarian Cyst (3) Pedunculated Gastmentioning

confidence: 99%

“…There have been few reports in English of a wandering abdominal mass. Most such cases are wandering spleen with a cyst (1,2)…”

mentioning

confidence: 99%

A Wandering Pancreatic Mass

et al. 2010

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P i c t u r e 1 . T h e f i r s t c o n t r a s t -e n h a n c e d CT s c a n s h o we d a l a r g e ma s s o f 5 7 mm i n s i z e wi t h h e t e r og e n e o u s c o n t r a s t e n h a n c e me n t i n t h e h e a d t o b o d y o f t h e p a n c r e a s o n t h e r i g h t s i d e o f t h e a o r t a ( A) . T wo mo n t h s a f t e r t h e f i r s t CT , a CT s c a n p e r f o r me d b e f o r e s u r g e r y s h o we d a s h i f t o f t h e l a r g e ma s s t o t h e b o d y t o t a i l o f t h e p a n c r e a s o n t h e l e f t s i d e o f t h e a o r t a ( B ) . PICTURES IN CLINICAL MEDICINE A Wandering Pancreatic Mass

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Splenic cyst in a wandering spleen: laparoscopic treatment with preservation of splenic function

Cited by 14 publications

References 14 publications

Non-operative management of a rare diagnosis of splenic torsion in a child with a history of giant omphalocele: a case report and literature review

Non-operative management of a rare diagnosis of splenic torsion in a child with a history of giant omphalocele: a case report and literature review

Kyste hydatique primitif de la rate: deux cas. Peut-on être conservateurs ?

A Wandering Pancreatic Mass

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