Fontaine-Nicola Andres, Ruiz-Cota Patricia, Broderick Ryan
Division of Minimally Invasive Surgery, Department of Surgery, University of California San Diego, San Diego, CA 92093, USA.
Division of Minimally Invasive Surgery, Department of Surgery, University of California San Diego, San Diego, CA 92093, USA.
Int J Surg Case Rep. 2025 Aug;133:111632. doi: 10.1016/j.ijscr.2025.111632. Epub 2025 Jul 9.
Splenic cysts are rare lesions typically discovered incidentally through imaging. While many are asymptomatic, large or symptomatic cysts may require surgical intervention to avoid complications. Advances in surgical technique and recognition of splenic function have shifted treatment from routine splenectomy toward organ-preserving approaches.
A 25-year-old male presented with early satiety, nausea, intermittent vomiting, and persistent left shoulder pain. Imaging revealed a 15 cm unilocular splenic cyst incidentally discovered during a Computed Tomographic Angiography (CTA) for asthma exacerbation. Magnetic Resonance Imaging (MRI) findings favored a chronic hematoma or epithelial cyst. Interventional radiology (IR)-guided aspiration ruled out malignancy or infection. Due to persistent symptoms and lesion size, the patient underwent laparoscopic fenestration. Pathology confirmed a benign fibrous cyst wall and splenic debris. The postoperative course was uneventful, and the patient remained asymptomatic at follow-up.
Nonparasitic splenic cysts are rare and often incidentally discovered. While frequently asymptomatic, large cysts can cause nonspecific symptoms and present diagnostic challenges. Imaging and aspiration may guide management, but definitive surgical intervention is often required due to recurrence risk and inconclusive findings. Laparoscopic fenestration allows for effective treatment while preserving splenic function, minimizing morbidity, and long-term immunologic risks.
Laparoscopic fenestration is a safe and effective treatment for symptomatic giant splenic cysts. In appropriately selected patients, spleen preservation can be achieved with favorable outcomes and minimal complications.
脾囊肿是罕见的病变，通常通过影像学检查偶然发现。虽然许多脾囊肿无症状，但大的或有症状的囊肿可能需要手术干预以避免并发症。手术技术的进步和对脾功能的认识已使治疗从常规脾切除术转向保留器官的方法。
一名25岁男性出现早饱、恶心、间歇性呕吐和持续的左肩疼痛。影像学检查显示，在因哮喘加重进行计算机断层血管造影（CTA）时偶然发现一个15厘米的单房性脾囊肿。磁共振成像（MRI）结果倾向于慢性血肿或上皮囊肿。介入放射学（IR）引导下的穿刺排除了恶性肿瘤或感染。由于症状持续和病变大小，患者接受了腹腔镜开窗术。病理证实为良性纤维囊肿壁和脾组织碎片。术后过程顺利，患者在随访时无症状。
非寄生虫性脾囊肿罕见，常偶然发现。虽然通常无症状，但大囊肿可引起非特异性症状并带来诊断挑战。影像学检查和穿刺可指导治疗，但由于复发风险和不确定的检查结果，往往需要进行确定性手术干预。腹腔镜开窗术可在保留脾功能的同时实现有效治疗，将发病率和长期免疫风险降至最低。
腹腔镜开窗术是治疗有症状的巨大脾囊肿的一种安全有效的方法。在适当选择的患者中，可以实现脾保留，效果良好且并发症最少。
