Oversized pseudocysts of the spleen: Report of two cases: Optimal management of oversized pseudocysts of the spleen.
BACKGROUND
Pseudocysts of the spleen are usually asymptomatic and associated with a history of trauma, infection or infarction. In this report, we present two uncommon cases of solitary, oversized pseudocysts of the spleen.


METHODS
Two patients (cases A and B), with symptoms of abdominal pain, were investigated. The laboratory and ultrasound examination confirmed the diagnosis of a large, non-parasitic splenic cyst in both cases. Computed tomography described an oversized pseudocyst occupying almost the entire splenic parenchyma in both cases and in patient A, the cyst was located in the splenic hilum. The medical history revealed a previous abdominal injury only in case A. The two patients underwent an open total splenectomy. The pathology examination verified the diagnosis of a non-parasitic splenic pseudocyst.


CONCLUSIONS
Both patients presented with symptoms, in contrast to the majority of patients with splenic cysts. The medical history of patients with splenic pseudocysts does not always reveal the cause of the pseudocyst formation. Any type of spleen-sparing procedure is not easy to perform in cases of surgical and anatomical difficulty, because of recurrence and the risk of intractable bleeding from the spleen.


CONCLUSIONS
Partial splenectomy is the recommended method for parenchymal preservation, but total splenectomy is preferred when the splenic cyst is oversized or cannot be excised with safety.
Department of General Surgery, General Hospital of Chalkis, 48 Gazepi Street, Chalkis 34100, Evia, Greece. Electronic address: georgegalyfos@hotmail.com.
George
G
Galyfos
Department of General Surgery, General Hospital of Chalkis, 48 Gazepi Street, Chalkis 34100, Evia, Greece.
Zisis
Z
Touloumis
Department of General Surgery, General Hospital of Chalkis, 48 Gazepi Street, Chalkis 34100, Evia, Greece.
Konstantinos
K
Palogos
Department of General Surgery, General Hospital of Chalkis, 48 Gazepi Street, Chalkis 34100, Evia, Greece.
Konstantinos
K
Stergios
Department of General Surgery, General Hospital of Chalkis, 48 Gazepi Street, Chalkis 34100, Evia, Greece.
Maria
M
Chalasti
Department of General Surgery, General Hospital of Chalkis, 48 Gazepi Street, Chalkis 34100, Evia, Greece.
Nikolaos
N
Kavouras
Department of General Surgery, General Hospital of Chalkis, 48 Gazepi Street, Chalkis 34100, Evia, Greece.
Laurant
L
Lavant
Non-parasitic splenic cyst; Oversized pseudocyst; Pseudocyst of the spleen; Solitary pseudocyst; Splenectomy