Laparoscopic fenestration and omentopexy as treatment for large splenic pseudocyst

Abstract

Introduction and importance Pseudocysts of the spleen are rare entities with cystic lesions of the spleen being uncommon in general. It is estimated that splenic cysts occur in about 0, 07% of the population1. In general, splenic cystic lesions are discovered incidentally or by mass effect. In the literature, only a limited number of splenic cysts are reported. We report a case of splenic pseudocyst with mass effect where we used laparoscopic fenestration of the pseudocyst with omentopexy as a treatment of choice.

Case presentation The patient is a 62-year-old male with no previous history of trauma. He visited his GP for abdominal pain with flaring towards the left shoulder accompanied by early satiety, occasional obstipation, and breathing difficulties. He was referred to our hospital after enhanced computed tomography showed a 15 × 13 cm splenic cyst with displaced stomach and pancreatic tail medially and left kidney downward.

Management options were discussed with the patient and he opted for a laparoscopic approach.

In this case, we performed laparoscopic fenestration of the pseudocyst with omentopexy.

Clinical discussion Until recently splenectomy was the surgical treatment of choice for all large or symptomatic cystic lesions of the spleen2, however with growing knowledge about the protective role of the spleen an approach with spleen protection is advocated.

Conclusion There are many advantages to the laparoscopic approach of splenic cystic lesions and it may be the treatment of choice for this uncommon surgical problem.