title: Laparoscopic marsupialization of a giant posttraumatic splenic cyst.
abstract: OBJECTIVE
  Nonparasitic cysts are rare clinical lesions of the spleen. Causes include congenital malformations and trauma. Historically, management has entailed partial or total splenectomy using an open approach. Recently, laparoscopic approaches have been developed. In this report, we describe laparoscopic marsupialization of a giant splenic cyst (diameter > 15 cm).
  
  
  METHODS
  A 25-year-old African-American man presented with a 9-month history of early satiety, constipation, and left upper quadrant pain. Additionally, he reported blunt trauma to the abdomen 2 years earlier. Physical examination revealed a large, fixed, nontender left upper quadrant mass. Computed tomography scan confirmed a simple cyst within the spleen, measuring 20 x 25 cm. Echinococcus and Entamoeba histolytica serologies were negative. Laparoscopic exploration was performed. Four liters of brown fluid were aspirated and intraoperative cytology confirmed a nonparasitic cyst. The cyst wall was excised and the cavity was packed with omentum.
  
  
  RESULTS
  The patient's recovery was uneventful, and he was discharged to home tolerating a regular diet on postoperative day 3. At 6-month follow-up, the patient was asymptomatic and showed no evidence of recurrence.
  
  
  CONCLUSIONS
  Nonparasitic splenic cysts are rare lesions. Laparoscopic marsupialization is safe and effective for giant nonparasitic splenic cysts and should be considered the treatment of choice.
authors.affiliation: Tulane Center for Minimally Invasive Surgery, Tulane University Health Sciences Center, New Orleans, Louisiana, USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: Sierra
authors.forename: William C
authors.initials: WC
authors.lastname: Brunner
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Murphy
authors.forename: J Bruce
authors.initials: JB
authors.lastname: Dunne
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Scott
mesh_terms: D000007:Abdominal Injuries / Q000150:complications; D000328:Adult; D003560:Cysts / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D013154:Spleen / Q000293:injuries / Q000601:surgery*; D013158:Splenic Diseases / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome