SPLENIC CYSTS IN CHILDREN
Category: Pediatric Surgery
Abstract : Splenic cysts in children are either considered true epidermal (congenital), pseudocysts (post-traumatic), or infectious (echinococcus) in etiology. They are rare, benign, solitary cysts often producing few symptoms. They may present as a palpable mass in the left side of the abdomen or during evaluation for another abdominal problem. Ultrasound (large unilocular sonolucent cyst) is the most impor
Splenic cysts in children are either considered true epidermal (congenital), pseudocysts (post-traumatic), or infectious (echinococcus) in etiology. They are rare, benign, solitary cysts often producing few symptoms. They may present as a palpable mass in the left side of the abdomen or during evaluation for another abdominal problem.
Ultrasound (large unilocular sonolucent cyst) is the most important diagnostic method, and can be supplemented by CT-Scan. The lining of the cyst is a flattened endothelium surrounded by fibrous tissue. This mesothelium can produced carcinoembryonic antigen (CEA). Indications for surgery are: (1) risk of complications (rupture, bleeding), (2) size greater than 5 cm., (3) infectious etiology, and a (4) symptomatic child (pain, mass or splenomegaly). Their management formerly total splenectomy has changed to: interventional sonography with fluid aspiration (catheter placement), or partial splenic decapsulation (cystectomy); the result of recognition of the physiologic importance (hematologic and immunologic) of the spleen, together with the development of radiological imaging and operative surgery. Long term follow-up with radionuclide scans is recommended.
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