A Case of a Spontaneously Ruptured Splenic Cyst which was Primaryly Treated by Ascitic Drainage and Electively Operated on by Laparoscopic Dome Resection

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  • 腹腔ドレナージ後に待機的に腹腔鏡下天蓋切除術を施行した脾嚢胞破裂の1例
  • 症例 腹腔ドレナージ後に待機的に腹腔鏡下天蓋切除術を施行した脾囊胞破裂の1例
  • ショウレイ フクコウ ドレナージ ゴ ニ タイキテキ ニ フククウキョウ カ テンガイ セツジョジュツ オ シコウ シタ ヒノウホウハレツ ノ 1レイ

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Abstract

A 26-year-old man who had intermittent bouts of upper abdominal pain since the night before admission was seen at the emergency clinic in our hospital on the next morning because of worsening of the symptom late in September 2013. There was muscle guarding in the entire abdomen. Abdominal CT scan showed large quantities of ascites and a 12 × 12 cm atonic, irregular-shaped cyst connecting to the spleen. Echo-guided ascitic drainage denied a possibility of intestinal perforation from its biochemical specifics. Spontaneous rupture of a giant splenic cyst was thus diagnosed. After admission, intraabdominal drainage was conducted via the left lower quadrant of abdomen. We identified about 4,600 ml of brown clouded discharge to be drained from the drainage tube. On the next day his abdominal pain almost completely improved. After his general condition became stable, laparoscopic dome resection was performed on the 10th hospital day. The postoperative course was uneventful and he was discharged from the hospital on the 11th day after the operation. No recurrence has occurred as of 4 months after the operation.<BR>A total of 14 cases of ruptured splenic cyst have been reported so far, but no case of a ruptured splenic cyst treated by ascitic drainage followed by elective laparoscopic dome resection has been reported. Accordingly this case is presented here, together with a review of the literature.

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