Manejo laparoscópico de quiste esplénico gigante

Introduction: There are 800 cases reported in the literature. More frequent in the second and third decades of life. The cysts are classifi ed into true: parasitic and non-parasitic (dermoid, epidermoid, and neoplastic epithelial); and pseudocyst, secondary to trauma. They are asymptomatic, 40% are presented like this. Greater than 5 cm have risk of rupture, infection, hemorrhage; surgical treatment becomes necessary. Objectives: Review of the literature on therapeutic options. Case report: Female 18 years old, a year with abdominal pain, denied other symptoms. Came to the emergency for exacerbation of pain and increased volume. On examination with pallor, abdomen with increased volume in the left upper quadrant, matte percussion, splenomegaly up to umbilicus, without peritoneal irritation. Platelet 100, Echinococcus serology negative. CT: 18 x 15 cm giant splenic cyst. Diagnosis: giant splenic cyst, pancytopenia. Preoperative preparation: pneumococcal vaccination and Haemophilus, cover with ceftriaxone. Exploraty laparoscopy: supine position, 4 trocars. Puncture and drain cyst with splenectomy was performed. Findings: cyst in the upper pole, surrounded by parenchyma, 3 liters of sallow content, bleeding 800 mL. Pathology report-epidermal cyst 17 cm. Conclusions: The goals should be to prevent complications, prevent and control the cyst recurrence. Several therapeutic options: percutaneous drainage, marsupialization, fenestration, partial and total splenectomy.