Garza-Serna Ulises, Ovalle-Chao Christian, Martinez David, Flores-Villalba Eduardo, Diaz-Elizondo Jose A, Garza-Luna Ulises de Jesus
Escuela de Medicina, Instituto Tecnologico y de Estudios Superiores de Monterrey, Avenida Morones Prieto 3000, Colonia Los Doctores, CP 64710 Monterrey, Nuevo Leon, Mexico.
Escuela de Medicina, Instituto Tecnologico y de Estudios Superiores de Monterrey, Avenida Morones Prieto 3000, Colonia Los Doctores, CP 64710 Monterrey, Nuevo Leon, Mexico.
Int J Surg Case Rep. 2017;33:44-47. doi: 10.1016/j.ijscr.2017.02.013. Epub 2017 Feb 20.
Non-parasitic splenic cysts (NPSC) are a rare condition that makes difficult to know their true incidence and represent 10% of all benign splenic cysts, they can be either congenital with the presence of epithelial lining that originate from invagination of the capsular mesothelial lining or post-traumatic with absence of epithelial lining. We present our management of a splenic congenital cyst in a pediatric patient. A 10-year-old female patient presented to the clinic complaining with a 3-week abdominal pain at the left upper quadrant. An ultrasound showed an enlarged spleen with a thinned walled cystic image on the lower pole of 5cm. An abdominal CT confirmed the presence of a splenic cyst at the lower pole of the spleen of 5cm in diameter. Three-port laparoscopic partial splenectomy was done isolating and dividing the lower splenic artery and vein and the lower pole of the spleen with a vessel sealing device. Management of a non-parasitic splenic cyst is controversial: cystectomy, fenestration, percutaneous drainage and sclerotherapy have been previously described, most of them aiming to preserve spleen function and avoiding overwhelming post-splenectomy infection. Partial splenectomy seems the most effective one in terms of preserving spleen function and avoiding recurrence.
非寄生虫性脾囊肿(NPSC)是一种罕见疾病,很难确切知晓其真实发病率,占所有良性脾囊肿的10%。它们可以是先天性的,存在源于包膜间皮内衬内陷的上皮内衬;也可以是创伤后形成的,不存在上皮内衬。我们展示了对一名儿科患者的先天性脾囊肿的治疗。一名10岁女性患者到诊所就诊,主诉左上腹有3周的腹痛。超声显示脾脏增大,下极有一个壁薄的囊性影像,大小为5厘米。腹部CT证实脾脏下极存在一个直径5厘米的脾囊肿。采用三孔腹腔镜部分脾切除术,使用血管封闭装置分离并切断脾下动脉和静脉以及脾脏下极。非寄生虫性脾囊肿的治疗存在争议:此前已描述过囊肿切除术、开窗术、经皮引流和硬化治疗,大多数旨在保留脾脏功能并避免脾切除术后严重感染。就保留脾脏功能和避免复发而言,部分脾切除术似乎是最有效的方法。