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-  2018 

Primary Splenic Cyst – A rare Presentation

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Abstract:

Introduction: Spleen is an organ of immune function. It is usually a rare viscera for cystic lesions. Most of the lesions of the spleen are benign. Cysts of the spleen are classified into True or Primary cysts and False or Secondary cysts. Most of the cysts are incidental finding on radiology, and are asymptomatic otherwise. Sometimes the cysts may present with pressure symptoms because of the large size. When the size is large, there are chances of rupture of the Cyst presenting with surgical emergency Materials and methods: We are reporting a case of 35 years old lady who presented with chief complaints of pain upper abdomen for last one month. No other complaints apart from persistent, nonradiating pain. Spleen was palpable below the left costal margin. USG whole abdomen was suggestive of a large cystic lesion in the spleen. Hydatid cyst serology was negative. Since the patient was symptomatic and the cyst was large, it was decided to take up the patient for surgery. Splenectomy was done under general anaesthesia. Post-operative period was uneventful. Histopathology reported it to be an epidermoid cyst. Discussion: Splenic cysts are rare entities. Most of the times these are silent, congenital splenic cysts are also called epidermoid or epithelial cysts. They are not seen very commonly. Most of the times these are asymptomatic, if symptomatic then surgery is considered. These cysts are mostly lined by squamous epithelium lined. The secondary or the pseudocysts are mostly secondary to trauma. These are not lined by an epithelium. There are many options of managing a spelnic cyst – Deroofing, partial splenectomy, total splenectomy and aspiration. While deroofing and partial splenectomy are good options for small cysts, larger cysts need total splenectomy open or laparoscopically. Aspiration doesn’t give a good long-term result. Key words: Primary; Splenic Cyst; Presentation; Immune function

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