Hao M Wu1, John B Kortbeek. 1. Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
Abstract
BACKGROUND: Post-traumatic splenic pseudocysts are uncommon. The optimal treatment is not well defined. METHODS: A retrospective chart review was conducted at the three adult hospitals in the Calgary Health Region. RESULTS: Six cases of splenic pseudocysts were found over a 6-year period. One splenic pseudocyst spontaneously resolved. A second splenic cyst was removed by open splenectomy. The remaining 4 patients were all first treated with percutaneous drainage. However, 3 of the 4 cysts recurred. Two of these 3 recurrent cysts were treated with laparoscopic fenestration, and all subsequently recurred; 1 of these patients later developed a splenic abscess. The third patient had a repeat percutaneous drain with subsequent recurrence. The last patient died of sepsis secondary to an iatrogenic punctured colon. CONCLUSIONS: Percutaneous drainage and laparoscopic fenestration have an unacceptably high rate of failure. Partial or complete splenectomy should be considered for young and otherwise healthy patients who have large symptomatic splenic pseudocysts.
BACKGROUND: Post-traumatic splenic pseudocysts are uncommon. The optimal treatment is not well defined. METHODS: A retrospective chart review was conducted at the three adult hospitals in the Calgary Health Region. RESULTS: Six cases of splenic pseudocysts were found over a 6-year period. One splenic pseudocyst spontaneously resolved. A second splenic cyst was removed by open splenectomy. The remaining 4 patients were all first treated with percutaneous drainage. However, 3 of the 4 cysts recurred. Two of these 3 recurrent cysts were treated with laparoscopic fenestration, and all subsequently recurred; 1 of these patients later developed a splenic abscess. The third patient had a repeat percutaneous drain with subsequent recurrence. The last patient died of sepsis secondary to an iatrogenic punctured colon. CONCLUSIONS: Percutaneous drainage and laparoscopic fenestration have an unacceptably high rate of failure. Partial or complete splenectomy should be considered for young and otherwise healthy patients who have large symptomatic splenic pseudocysts.
Authors: Bruno de la Villeon; Alban Zarzavadjian Le Bian; Helene Vuarnesson; Nicolas Munoz Bongrand; Bruno Halimi; Emile Sarfati; Pierre Cattan; Mircea Chirica Journal: Surg Endosc Date: 2014-06-25 Impact factor: 4.584