title: Laparoscopic treatment of intrasplenic pancreatic pseudocyst.
abstract: BACKGROUND
  Pseudocyst formation commonly follows pancreatitis, but erosion into the spleen is rare and potentially life threatening. We report a case of an intrasplenic pancreatic pseudocyst treated laparoscopically 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 suspicious for an intra-splenic pseudocyst. The patient underwent laparoscopic distal pancreatectomy and splenectomy.
  
  
  RESULTS
  There were no intraoperative complications 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 involvement is an unusual complication of pancreatic 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 effective method of treatment without the potential complication of a large abdominal incision.
authors.affiliation: The Bariatric and Metabolic Institute, Section of Minimally Invasive Surgery, Cleveland Clinic, Florida, Weston, FL, USA. lomenze@ccf.org.
authors.forename: A
authors.initials: A
authors.lastname: Abdemur
authors.forename: S
authors.initials: S
authors.lastname: Johnson
authors.forename: G
authors.initials: G
authors.lastname: Barsoum
authors.forename: A
authors.initials: A
authors.lastname: Cappellani
authors.forename: A
authors.initials: A
authors.lastname: Zanghì
authors.forename: M
authors.initials: M
authors.lastname: Di Vita
authors.forename: A
authors.initials: A
authors.lastname: Cavallaro
authors.forename: D
authors.initials: D
authors.lastname: Spartà
authors.forename: S
authors.initials: S
authors.lastname: Szomstein
authors.forename: R
authors.initials: R
authors.lastname: Rosenthal
authors.forename: E
authors.initials: E
authors.lastname: Lo Menzo
mesh_terms: D004322:Drainage / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods; D010192:Pancreatic Pseudocyst / Q000473:pathology / Q000601:surgery*; D019512:Pancreatitis, Alcoholic / Q000473:pathology; D013156:Splenectomy / Q000379:methods; D013158:Splenic Diseases / Q000473:pathology / Q000601:surgery*