Epithelial splenic cysts and life-threatening splenic rupture

Abstract

Background/aim: Primary splenic cysts are relatively uncommon and in the majority of cases are classified as epithelial cysts which are more frequent in young patients. Most of them are asymptomatic, and they are found incidentally during imaging techniques or laparotomy. We report two rare cases of patients with epithelial splenic cysts as an incidental finding during emergency laparotomy for splenic rupture.

Materials and method: The first patient was a 70-year-old man who presented with symptoms of acute abdomen after intensive cough during an episode of asthma. Emergency laparotomy findings were splenic rupture and intraperitoneal haemorrhage. A splenectomy was performed and the histological examination showed a ruptured spleen with an epithelial cyst. The second patient was a 19-year-old man who was transferred to the Emergency Department in hypovolemic shock due to intraperitoneal bleeding after a blunt abdominal injury. During laparotomy a splenic rupture was found, and an epithelial cyst.

Conclusion: Epithelial splenic cysts are a rare entity and they can be an incidental finding during the surgical treatment of a spleen rupture and haemoperitoneum. These cysts may be a predisposing factor to splenic rupture in cases of increased intraabdominal pressure or blunt abdominal trauma.