Chapter 72 The Spleen and Its Disorders
Management of Splenic Cysts
A 37-year-old woman with no past medical history comes in for evaluation of early satiety and left shoulder pain. She reports that she feels full after only a few bites of any meal and sometimes becomes nauseated and vomits. Physical examination is remarkable for an enlarged nontender spleen. Imaging shows a large splenic cyst.
• Many conditions can lead to cyst formation in the spleen, including parasitic infections, trauma, hemangiomas, and polycystic kidney disease.
• Asymptomatic nonparasitic cysts may be observed with careful attention and development of a plan for intervention should they become symptomatic, rupture, or become infected.
• Symptomatic cysts may require percutaneous drainage with radiologic guidance or sometimes surgical procedures, including partial or total splenectomy.*
• Parasitic cysts should be treated in consultation with infectious disease specialists because the particular parasitic infection, radiologic appearance, and patient comorbidities will guide choice of therapies.
Figure 72-1 RED BLOOD CELL FINDINGS IN HYPOSPLENISM.
A, Red blood cells with Howell-Jolly bodies. B, Nucleated red blood cell. C, Cells with Pappenheimer bodies. Red blood cells with Howell-Jolly bodies are seen in patients with hyposplenism. The cytoplasmic inclusions (A)