Posttraumatic splenic pseudocyst

Abstract

Background. Posttraumatic splenic pseudocyst is a rare complication of splenic trauma. In the specialized anglo-saxon literature, the unique cases of formation of the posttraumatic splenic pseudocyst are described. Case report. The 65-year-old female patient is admitted to the Emergency Medicine Institute of Chisinau, the Department of Surgery no.1, presenting abdominal pain in the left hypochondrium with ascending irradiation. From her personal history we note: 4 months ago she suffered a trauma by falling down in the mountains, falling from her own height on a stonebench. At the primary consult, she was examined clinically and paraclinically, the home patient monitoring was prescribed. For 3 months the patient undergoes an imaging examination (USG, Angio-CT), but without establishing a definitive treatment behavior. At the onset of symptoms, she is hospitalized and repeatedly undergoes a laboratory and imaging examination. Results. Imaging investigations indicated a giant posttraumatic splenic pseudocyst, located on the diaphragmatic surface of the spleen, with dimensions 141x90x118mm and volume ~ 750ml, with hyperechogenic, fibrinous, polymorphous, floating elements, the biological picture is not relevant. Laparoscopic surgery - pericystectomy with spleen preservation was performed. Postoperative evolution was favorable. Conclusions. The posttraumatic pseudocyst may be a consequence of the nonoperative attitude of the traumatic spleen injuries, its evolution requiring careful clinical and imaging monitoring in the dynamic. Laparoscopic surgical resolution presents a safe solution, as an alternative for posttraumatic splenic pseudocysts, the spleen preservation remaining the main objective of the treatment.