Less invasive surgery in idiopathic scoliosis: a case report

INTRODUCTION: Pseudocyst formation commonly follows pancreatitis, but erosion into the spleen is rare and potentially life threatening. We report a case of an in - trasplenic pancreatic pseudocyst treated la - paroscopically with distal pancreatectomy and splenectomy. METHODS: A 50 year old male with a history of chronic alcoholic pancreatitis, presented with abdominal pain for 3 months, worsening over the past several days. A CT scan showed a broad 9 cm subcapsular fluid collection suspi - cious for an intra-splenic pseudocyst. The pa - tient underwent laparoscopic distal pancreatec - tomy and splenectomy. RESULTS: There were no intraoperative com - plications and the patient was discharged on day 8. The final pathology revealed a benign cystic lesion measuring 9 x 6 x 3 cm that was not communicating with the pancreatic duct, and 2 smaller pseudocysts in the pancreatic body and tail. A previous scan did not reveal any abnormalities in the spleen, and showed the other pancreatic pseudocysts. At 8 month follow up the patients was symptom free, with no new pseudocysts. CONCLUSIONS: Splenic parenchyma in - volvement is an unusual complication of pan - creatic pseudocyst. The optimal treatment is controversial. Percutaneous drainage carries a high recurrence rate and risk of hemorrhage. Open surgery is effective, but associated with significant morbidity. Laparoscopy offers an ef - fective method of treatment without the poten - tial complication of a large abdominal incision.