Pseudocisto esplênico

um relato de caso

Abstract

Introduction: Splenic cysts are rare findings in medical practice. They can be classified into non-parasitic and parasitic cysts. Non-parasitic cysts are further classified as primary and secondary. Primary cysts are more common in children and young adults, having a congenital origin, while pseudocysts are secondary mainly to trauma, splenic infarction or infectious processes. Case report: Patient 24 years old, female, sought medical attention at the Naval Hospital of Salvador in March 2019 due to severe abdominal pain in the left hypochondrial region that radiated to the ipslateral shoulder. Physical examination revealed hepatomegaly and splenomegaly. TC scan revealed the presence of a splenic cyst measuring approximately 15.5 x 14.1 x 10.6 cm. Marsupialization of the cyst was performed and a splenic pseudocyst was revealed in the anatomopathological study. Discussion: Surgery that preserves the spleen should be the first choice in the treatment of non-parasitic cysts whenever possible. Techniques such as partial splenectomy and marsupialization are good options for superficial cysts. Splenectomy is indicated if the spleen is larger than 5 cm, intraparenchymal cyst, cystic dimension occupying almost all of the splenic parenchyma, location in splenic hilum or presence of multiple cysts, constituting a safe approach. Conclusion: Large splenic cysts (greater than 5 cm) and symptomatic should be treated surgically. Several surgical techniques are avaiable for management. Conservative options must be the fist choice when
possible due the high risk of septicemia after splenectomy.