Cyst Of Spleen Research Articles

Artificial intelligence iterative reconstruction in abdominal CT of patients with irregular arm positioning: a case-by-case evaluation.

Streak artifacts induced by irregular arm positioning have been an issue in diagnosing the abdomen. To illustrate the risk of misdiagnosis in abdominal computed tomography (CT) of patients with irregular arm positioning through a case-by-case evaluation and to test if it can be solved by the artificial intelligence iterative reconstruction (AIIR) algorithm. By reviewing 5220 cases of chest and thoracoabdominal CT, 64 patients with irregular arm positioning were enrolled, whose image data were reconstructed using AIIR in addition to routine hybrid iterative reconstruction (HIR). Lesion detection for livers, spleens, kidneys, gallbladders, and pancreas on AIIR images, performed by two radiologists, was compared with those on HIR images. Discrepancies arising from AIIR images included both cases with additional abnormalities and those with corrections made on previous detections. For cases with discrepancies, artifact scores for organs where discrepancies were found, and contrast-to-noise ratios (CNRs) of cysts with discrepancies were compared between two image sets. Additional abnormalities were detected for 15 cases: additional liver cirrhosis (n=2); additional gallbladder stone (n=1); additional cholecystitis (n=1), additional spleen nodule (n=1); additional kidney cysts (n=8); additional liver cysts (3); and additional spleen cyst (n=1). A spleen contusion was corrected for one case. All involved artifact scores were improved on AIIR images. CNRs of involved liver, kidney, and spleen cysts were improved by up to 539.7%, 538.5%, and 245.5%, respectively. Irregular arm positioning may induce a variety of misdiagnoses in abdominal CT, which is almost totally avoidable by the AIIR algorithm.

Use of HugoTM RAS in General Surgery: The First 70 Cases at a German Centre and a Systematic Review of the Literature.

Introduction: The versatile open modular design of the newly introduced robotic platform HugoTM RAS is expected to allow its rapid spread in general surgery. However, the system is not yet approved for use in oesophageal and HPB-surgery and is not licensed worldwide. The aim of this work was to review the current spectrum of general surgical procedures that may be feasibly and safely performed with Hugo. Methods: We retrospectively reviewed our own series and performed a systematic review of all the published reports of general surgical procedures performed with this system in the literature. Results: Seventy patients underwent general surgery with Hugo at our institution, and another 99 patients were reported in the literature. The most common procedures were colorectal (n = 55); cholecystectomy (n = 44); repair of groin, ventral and hiatal hernias (n = 34); upper GI (n = 28); adrenalectomy (n = 6); and spleen cyst deroofing (n = 2). No device-related complications were reported. Arm collisions and technical problems were rare. The docking and console times improved in all series. The port positions and robotic arm configurations varied among authors and depended on the surgical indication, patient characteristics and surgeon's preference. Conclusions: A wide spectrum of general surgical procedures has been safely and effectively performed with the Hugo RAS, even by robotically inexperienced teams with a limited choice of instruments. Technical improvements to the system and the introduction of robotic energy devices may help Hugo evolve to a vital alternative to established robotic systems.

Minimally Invasive Methods of Treatment of Nonparasitic Spleen Cysts

Minimally Invasive Methods of Treatment of Nonparasitic Spleen Cysts

Robot-assisted treatment of spleen cysts in children: first experience

Robot-assisted treatment of spleen cysts in children: first experience

Giant non-parasitic splenic cyst: a case report

BackgroundSplenic cysts are quite rare and asymptomatic. They may result from infection by a parasite, especially Echinococcus granulosus (hydatid cyst), or from non-parasitic causes. Since primary splenic cysts are not common, simple cysts can be misdiagnosed with a hydatid cyst in endemic areas.Case presentationWe reported a 14-year-old Iranian girl initially presented with a vague abdominal pain, which progressed to left shoulder pain, fullness, early satiety, and shortness of breath and remained undiagnosed for 7 months despite seeking medical attention. Finally, imaging revealed a massive splenic cyst measuring 220 mm × 150 mm × 160 mm raising concern for a hydatid cyst due to regional endemicity. Consequently, the patient underwent total splenectomy. However, histopathological examination surprisingly revealed a simple non-parasitic cyst.ConclusionsDetecting rare simple spleen cysts requires early ultrasonography (US) and careful reassessment of diagnoses for non-responsive or worsening symptoms. Distinguishing them from splenic hydatidosis, especially in endemic areas, demands thorough paraclinical evaluations and patient history regarding potential parasitic exposure. While total splenectomy is the primary treatment for these huge cysts, the optimal surgical approach should be tailored case by case. These insights emphasize a comprehensive diagnostic approach to enhance accuracy and optimize patient care for these uncommon cysts.

Primary Splenic Hydatid Cyst: Case Report

The rarity of splenic hydatid disease poses a challenge for clinicians, particularly in non-endemic areas. As the hydatid cyst can present as a simple cyst without having the classical symptoms and later can lead to life-threatening complications; Serology and featuring images are necessary for the diagnosis. The treatment is mainly surgical with, in particular the total splenectomy In this article, we report a case of Hydatic cyst of spleen treated at the Department of Visceral Surgery of the Hospital ibn tofail CHU Mohammad VI Marrakesh.

Retrospective assessment of the clinical efficacy of laparoscopic partial splenectomy.

The present study aimed to explore the clinical efficacy of laparoscopic partial splenectomy in the treatment of benign lesions of the spleen and partial splenic rupture. The clinical value of laparoscopic partial splenectomies performed between March 2015 and May 2022 was retrospectively analyzed. Cases considered included the following: 14 spleen cysts, five spleen hemangiomas, one spleen hamartoma and two splenic ruptures. Lesion diameters of cases ranged from 5.0-11.3 cm. Results indicated that all 22 patients had an uneventful surgery, including 11 cases with lesions located in the upper pole of the spleen, nine in the lower pole of the spleen, one in the upper middle pole and one in the middle and lower pole. Operation time ranged from 75-180 min (mean: 120±17 min) and intraoperative bleeding ranged from 80-300 ml (mean: 178±70 ml). The average duration of postoperative hospitalization was 6±2 days, with all patients followed up for 10-12 months. Patients reported no symptoms of discomfort and had platelet levels within normal range. In conclusion, laparoscopic partial splenectomy allows for lesion resection while retaining normal splenic function and may be effectively used for treating benign spleen tumors and partial splenic rupture. However, the operation is difficult and surgeons must be able to perform minimally invasive techniques and strictly screen cases.

Acute Abdomeninal Pain Developed Due to Hydatic Rupture of Liver and Spleen Cyst at Different Times: A Very Rare Case

Acute Abdomeninal Pain Developed Due to Hydatic Rupture of Liver and Spleen Cyst at Different Times: A Very Rare Case

Lesion Characterizations, Associated Risk Factors and Financial Implication of Zoonotic Hydatid Cyst of Dromedary Camels Slaughtered at Addis Ababa, Akaki Kality Municipal Abattoir, Ethiopia

Hydatid cyst, is zoonotic helminthic parasites of Taeniid families having significant economic crisis in the world. A cross-sectional study was conducted from October 2021 to May 2022 to characterize hydatid cyst lesions, analysis of associated risk factors and estimate annual direct financial loss due to hydatid cyst infected organs condemnation during postmortem examination in dromedary camels slaughtered at Addis Ababa, Akaki Kality Municipal abattoir, Ethiopia. A total of 370 camels were purposively sampled and systemic meat inspection was employed to detect the presence of hydatid cyst. Out of 370 hydatid cysts like cases examined in different organs, 96 (25.9%) camels were found harboring hydatid cyst. The percentage of hydatid cyst in adult camels were 29.67%; OR= 1.54 while in young it was 18.55%. Likewise, the prevalence of hydatid cyst in poor, medium and good body condition score was 61.4%; OR= 10.79, 30.89%; OR= 3.30 and 12.11% respectively. Results indicated that age and body condition score had statically significant effect (P<0.05) on prevalence of hydatid cyst. The overall prevalence of hydatid cyst in male dromedary camel was (14.59%; OR=0.83;) found higher than female (11.35%). The overall prevalence of hydatid cyst in camels originated from Borana, East Hararge, Jigjiga, Karrayyu, Matahara, Minjar-shenkora and Wollo were 9.18%, 0.54%; OR= 2.12, 4.86%; OR= 2.06, 3.51%; OR= 1.18, 3.78%; OR= 0.94, 1.08%; OR= 0.78 and 2.97%; OR= 1.31, respectively. Result indicated, origin and sex didn’t have significant effect (P>0.05) on the overall prevalence of hydatid cyst. Out of 96 total infected camels, only 9 (9.38%) cases had hydatid cyst on both lung and liver while the remaining 87 (90.62%) cases had hydatid cysts only in single organs. Of 105 total infected organs, percentage of distribution of hydatid cyst in lungs, livers, spleen and heart were 87.61%, 10.47%, 0.95% and 0.95% respectively. Result showed that out of 105 examined organs of camels, 51 organs harboring less than three hydatid cysts number while 54 organs had greater than or equal to three hydatid cysts. Grossly, hydatid cyst of lung had a shape of cotton ball, implanted in lung parenchyma, filled with clear to slightly turbid fluid, soft and malleable to touch and inside white germinal layer while hydatid cyst on the livers was firm, calcified and strong when it was about to be cut off. Microscopically, hydatid cyst structure overlying organs had a fibrous layer on the external (pericyst), an acellular eosinophilic laminated membrane layer on the middle (ectocyst) and a germinal layer internally (endocyst) and protoscolices were also seen in a lung section. Fibrous layer had infiltration of epitheliod macrophages, lymphocytes and eosinophils showed inflammatory reaction response to hydatid cyst layer and cellular infiltration was lessened when they went away from hydatid cysts. Histopathology of lung infected with hydatid cyst displayed massive alveolar damage, some alveoli was emphysematous, congested capillary, hemorrhage and atelectasis in the fibrous layer. In hydatid cyst infected liver histology, there was hemorrhage, hepatocyte degeneration and cytoplasmic swelling with dilation of nucleus in fibrous layer. Microscopically, hydatid cyst infected heart had not a visible protoscolices and it had weak germinal and lamination layer followed by lymphocyte and epitheloid macrophages infiltration. The total annual direct financial loss due to hydatid cyst was estimated at 86,209.63 Ethiopian birr. Hereafter, this study helps to stress the economic consequences and pathological patterns of hydatid cysts at abattoir, and creation of public awareness and control of stray dogs in order to reduce infection by the parasite were suggested recommendation.

Laparoscopic cystectomy for a giant splenic cyst in a 8-year old child

Introduction. Nonparasitic splenic cysts (PNSC) are rare, with a frequency of 0–2 % of all diseases of the spleen. Primary cysts account for about 30–40 % of all spleen cysts and are more common in children than in adults. Most cysts are asymptomatic. The usual clinical picture of large spleen cysts includes: pain or discomfort in the upper left abdomen, often accompanied by a feeling of overflow in the stomach. Spleen cysts larger than 5 cm are more prone to complications such as bleeding, rupture or infection, therefore surgical treatment is recommended. Development of endoscopic surgical techniques and modernization of imaging diagnostics have significantly changed management of spleen cysts. Thorough and accurate preoperative examination, precise location and topography of the cyst and surrounding structures increase chances for an organ-spearing surgical intervention. Nevertheless, in some cases, splenectomy is the only possible way of radical treatment. To date, the following types of intervention are most commonly applied: percutaneous cyst puncture with sclerotherapy, partial resection of the spleen and cyst fenestration which may be made both endoscopically and in the traditional way. Description of clinical observation. This article describes a clinical case of a giant spleen cyst revealed at the outpatient examination for abdominal pain. The child was hospitalized. During the inpatient examination, asymmetry of the abdominal wall was found; a densely elastic rounded formation was palpated in the left hypochondrium. The patient was thoroughly examined: ultrasound of the abdominal cavity which revealed a cystic formation of the spleen and MRI. ELISA test did not reveal antibodies to Echinococcus. Laparoscopic cystectomy was performed. Conclusion. This clinical case is an example of modern approach to the surgical treatment of giant non-parasitic spleen cysts with minimally invasive and organ-sparing tactics.

A case of isolated multiple hydatid cysts of spleen

Isolated splenic hydatid disease is an extremely rare entity accounting for less than 3% of the total incidence of Echinococcosis. We present a case of 26yr female presenting with pain in the left hypochondrium and low-grade fever. CECT abdomen showed three loculated lesions in spleen features suggestive of hydatid cysts. She underwent splenectomy with a specimen that showed multiple splenic hydatid cysts. This case report highlights the rare presentation of isolated multiple hydatid cysts of the spleen and its successful diagnosis and treatment.

Incidence of thyroid nodules in early stage autosomal polycystic kidney disease

BackgroundAutosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. Defect in cilia-mediated signaling activity is a crucial factor leading to cyst formation. Hence, ADPKD is regarded as a systemic disorder with multiple extrarenal complications, including cysts in other organs, for instance, the liver, pancreas, spleen, or ovaries. Interestingly, loss-of-function of primary cilia has been recently found to contribute to a malignant transformation from degenerated thyroid follicles. However, the increased incidence of thyroid nodules in ADPKD patients has not yet been fully confirmed.ObjectivesTo determine the incidence of thyroid lesions in patients with ADPKD in comparison to previous population studies. Moreover, we aimed to investigate if the pace of the disease progression is associated with a higher prevalence of thyroid lesions.Material and methodsIn 49 early-stage ADPKD patients recruited from our center, we performed ultrasonography of the thyroid glands, and laboratory evaluation of thyroids function. We compared the results with population studies.ResultsTwenty-three individuals had solid, cystic-solid, or cystic lesions revealed in the ultrasonography and 2 patients had a positive past medical history for thyroidectomy due to nodular goiter. In 10 patients out of the 23, only minor cysts with no clinical significance were found and 13 out of the 23 patients had solid or cystic-solid lesions, which occurred to be benign based on three years of follow-up or the biopsy of the nodule.ConclusionsWe found no increased incidence of thyroid gland lesions in early ADPKD patients in comparison to previous population studies. Plausibly, mechanisms other than defective cilia signaling are involved in the risk for focal thyroid lesions formation. Moreover, the rate of progression of kidney function decline seems to be not accompanied by the higher incidence of thyroid pathology.

A Rare Case Report- An Incidental Finding of Isolated Unilocular Splenic Hydatid Cyst

Splenic Hydatid Cyst is a very rare presentation with less than 5% of total incidences of Cystic Echinococcosis. It is usually due to spread of cysts from other regions leading to secondaries. Primary isolated splenic hydatid cyst without involvement of any other organs is even rarer. We report an unusual case of a female who presented as Abnormal Uterine Bleeding (AUB) with an incidental finding of Isolated Splenic Hydatid Cyst with absence of involvement of any other organ. Patient underwent laparotomy and total splenectomy was done. This case report targets to report a rare case of incidental finding of isolated unilocular hydatid cyst of spleen and describes its management.

HIPERTENSIUNE PORTALĂ STÂNGĂ PRIN CHIST HIDATIC LIENAL

Left portal hypertension, caused by hydatic cyst of spleen is a rare complication. We present the clinical case of a 41 years old patient, diagnosed and surgically managed in our clinic. Positive diagnosis was confirmed by imaging methods and intraoperatively. Splenectomy, associated in postoperative period with antiparasitic medication and β-blockers, had a positive influence over the disease evolution.

ПЕРВЫЙ ОПЫТ ЛАПАРОСКОПИЧЕСКОЙ РЕЗЕКЦИИ КИСТЫ СЕЛЕЗЁНКИ (СЛУЧАЙ ИЗ ПРАКТИКИ И КРАТКИЙ ОБЗОР ЛИТЕРАТУРЫ)

Background. Cystic lesions of the spleen are not an uncommon pathology, however, until now clear criteria for the scope of surgical interventions are not clearly defined and depend on a number of anatomical and clinical features of this pathology, and laparoscopic resection is still a surgical challenge. Purpose. Preliminary analysis of the results of laparoscopic resection of spleen cysts, as well as the study of the current literature on the subject. Material and methods. This article presents a clinical case from the authors' personal experience with the diagnosis and treatment of a patient with a spleen cyst. Laparoscopic method was used in surgical treatment. In selecting it, a number of relevant medical literature was studied and analyzed. Results. As a result of a successful laparoscopic resection the patient managed to save such an important organ for homeostasis maintenance as the spleen. Postoperative complications were also avoided. Conclusions. Organ-preserving and minimally invasive interventions should remain the priority at the current stage of surgery development. In the treatment of such pathology as spleen cysts, planned approach is preferable, which allows for maximum preoperative diagnosis. It should take into account the etiology and localization of the cyst, as well as the peculiarities of blood supply to the spleen in a particular patient.

Hydatid cyst of spleen: A rare presentation

: Hydatid cyst is a parasitic infestation caused by Echinococcus granulosus. The spleen being rarely involved by the parasite, commonly involved organs are liver followed by lungs. It constitutes only 4% of abdominal hydatid diseases. Its worldwide incidence is 0.5 to 4%. In this case report, we present a case of young boy with concomitant splenic and liver hydatid cysts. A 8-year-old boy, resident of Chamba district was presented with abdominal pain, fever and left upper quadrant swelling. The swelling had started enlarging over past 4 months. After necessary investigations it was diagnosed as hydatid cyst of spleen concomitant with liver and was confirmed by histopathological examination of the cyst membrane. All routine investigations other than anemia of 9.4 mg/dl and raised Ecchinococcus IGG serum levels, all other tests were within normal range. Splenic hydatid is a rare entity and among abdominal presentations of hydatid diseases its incidence is very low, being 4% only. Diagnosis can be made on CECT abdomen along with the Echinococcus IGG serum levels, cytology of aspirated cystic fluid and then can be confirmed on histopathological examination of the cyst membrane sent for the histopathological examination. This case report emphasizes the need of considering hydatid cyst as a differential with uncommon presentation of the disease even in non- endemic area, as in this case patient presented with splenomegaly and abdominal pain.

Консервативне (неінвазивне) ведення пацієнтів дитячого віку з кістами селезінки

Surgeons’ views on tactics for treatment of splenic cysts (SC) in children are widely discussed in the literature. Indications and methods of conservative (non-invasive) management (observation) of children with SC is different issue. Purpose – to develop rational tactical approache for conservative (non-invasive) management of children with SC. Materials and methods. A retrospective analysis of conservative (non-invasive) management of 90 (33.96%) of 265 patients with SC was performed. Children were not operated if the SC was less than 20 mm (n=61) in diameter. They were first monitored by ultrasound 2 times for 6 months, then – 2 times a year, until puberty. We did not observe the progression of cyst growth in these children. Also did not operate children in whom the size of SC was from 20 to 62 mm, had an asymptomatic course and parents did not consent to surgical treatment (n=29). This is the most difficult group of patients to analyze, as most of them lack information about the dynamic observation. According to the results of dynamic observation in 19 of 29 examined patients’ regression of SC was not observed, which later served as an indication for surgical treatment. Results and conclusions. In the presence of SC, a choice of surgical treatment or conservative (non-invasive) management is possible. Tactical approach for treatment of children with SC is strictly individual and depends on the size and location of the parenchymal lesion. In SC up to 20 mm diameter, conservative (non-invasive) management is rational, which is confirmed by the lack of progression of cyst growth in these children. Dynamic observation of patients with SC with a diameter of more than 20 mm without regression, serves as an indication for surgical treatment. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: spleen cyst, children, conservative, non-invasive, management, results.

Substantiation of organ-preserving surgical treatment of children with nonparasitic spleen cysts

BACKGROUND: The urgency of surgical treatment of children with nonparasitic spleen cysts is determined by the lack of consensus in the professional community, lack of regulatory documents governing the treatment of these patients, frequency of postoperative complications, and unfavorable outcomes.
 AIM: This study aimed to improve the efficiency and safety of organ-preserving minimally invasive interventions in children with nonparasitic spleen cysts based on the development of a multifactorial preoperative planning system and substantiation of an algorithm for choosing the optimal surgical strategies.
 MATERIALS AND METHODS: Results of surgical treatment of 60 children aged 218 yrs with nonparasitic spleen cysts are presented. The spleen cyst volume varied from 3 ml to 1000 ml (Me 50 ml). Preoperative examination included clinical examination, laboratory diagnostics, ultrasonography, computed tomography or magnetic resonance imaging, and angiography of the spleen vessels. The range of surgical technologies included percutaneous puncture (n = 2) and percutaneous puncture drainage (n = 28), followed by sclerosing of the cyst with 96% ethyl alcohol, combined interventions, supplemented by superselective embolization of the spleen arteries feeding the pathological formation (n = 15), laparoscopic fenestrations of cysts with physical de-epithelialization of the inner lining (n = 14), and laparoscopic resection of the spleen pole (n = 1).
 RESULTS: The analysis of postoperative complications was carried out depending on the chosen technology of surgical treatment. The follow-up period of 44 patients varied from 6 mon to 3 yrs, which made it possible to reveal the regularities of the reduction of residual cyst cavities and the course of the regeneration processes with an objective assessment of the volumetric characteristics of the spleen. Obliteration of the residual cyst cavities was observed in 79.1% of the patients during the first month after surgery. Subsequent total obliteration of the residual cyst cavities was observed within 1 yr after surgery in 91.7% of children and residual pathological formations persisted in five patients, which accounted for 8.3% of clinical observations. The volume of residual cysts ranged from 1.2% to 10.0% of the initial value, which was regarded as a satisfactory treatment result.
 CONCLUSION: Results of a retrospective multivariate analysis made it possible to develop an algorithm for substantiating surgical techniques, providing a radical cure for 95.5% of children with nonparasitic spleen cysts.

CME Sonography 96/Answers: Spleen Changes

CME Sonography 96/Answers: Spleen Changes Abstract. The spleen is a somewhat neglected organ but there are some changes that must not be neglected. Splenomegaly, caused worldwide most commonly by malaria, can occur in other infections, in portal vein thrombosis or in portal hypertension in the context of liver cirrhosis. An accessory spleen is also often found. Sometimes after splenectomy, small remains are found which may later hypertrophy. Where focal changes are concerned, we differentiate between various forms of spleen cysts, lymphomas, metastases, and benign tumors.

Spectrum of rare splenic lesions

Introduction: The human spleen is the largest component of the reticuloendothelial system, having unique anatomic and functional importance. Spleen has been considered as mysterious organ with World population incidence of focal splenic lesions ranging from 0.103 to 0.20%. Aims and Objective: The aim of the present study was to study the pathological spectrum of rare lesions of spleen. Materials and Methods: The present study was conducted in the department of Pathology in a tertiary care centre, over a period of three years from Aug 2014 to July 2017. Results: Total 10 rare cases of splenic lesions were studied. Out of which eight were splenectomies and two were from fetal autopsies. Primary lesions were 9 and secondary lesion was 1. We found one case each of hemangiomatosis of spleen, small B cell lymphoma of spleen, Sickling of spleen, hydatid cyst of spleen, traumatic spleen avulsion, metastasis to spleen from lung and two case were of asplenia with right isomerism and situsambigus and two cases were of extra lymphatic filariasis of spleen. Conclusion: Morphological changes in splenic lesions are less discussed due to fewer number of splenectomy cases. We hereby analyzed rare splenic lesions which has contributed to the knowledge of splenic pathology. Keywords: Pathological spectrum, Splenic lesions, Splenectomy.