title: A cause for conversion of laparoscopic splenectomy: splenic candidiasis.
abstract: Laparoscopic splenectomy (LS) is now considered the procedure of choice for removal of the spleen in several hematologic and traumatic splenic conditions. Perisplenitis is still considered a relative contraindication. We report a rare case of isolated splenic candidiasis treated by laparoscopic splenectomy. The technical challenges of the laparoscopic approach in cases of perisplenitis are outlined. Because of dense adhesions to the diaphragm, the LS was converted to open splenectomy, and the procedure was completed through a small subcostal incision. This case report suggests the need for and effectiveness of splenectomy in patients whose fungal infection is suspected to be localized to the spleen. Laparoscopic removal of the spleen in these cases is very difficult to accomplish because of the risk for diaphragm injuries and the technical problems encountered.
authors.affiliation: Department of Surgery, University of Catania, Vittorio Emanuele Hospital, Catania, Italy. rvecchio@mbox.unict.it
authors.forename: Rosario
authors.initials: R
authors.lastname: Vecchio
authors.forename: Emma
authors.initials: E
authors.lastname: Cacciola
authors.forename: Marcello
authors.initials: M
authors.lastname: di Martino
authors.forename: Rossella Rosaria
authors.initials: RR
authors.lastname: Cacciola
authors.forename: Bruce V
authors.initials: BV
authors.lastname: MacFadyen
mesh_terms: D000328:Adult; D002177:Candidiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000382:microbiology / Q000601:surgery*