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Case Reports in Gastrointestinal Medicine
Volume 2017, Article ID 9896856, 4 pages
https://doi.org/10.1155/2017/9896856
Case Report

A Rare Encounter with an Expanding Pseudocyst of the Spleen

Department of General Surgery, United Mission Hospital, Tansen, Palpa, Nepal

Correspondence should be addressed to Ashish Lal Shrestha; moc.oohay@ytnurghctub

Received 3 October 2017; Accepted 11 December 2017; Published 25 December 2017

Academic Editor: Olga I. Giouleme

Copyright © 2017 Ashish Lal Shrestha and Pradita Shrestha. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Splenic Pseudocyst (SP) is a diagnostic rarity, with cystic lesions of spleen themselves being uncommon. Establishing a preoperative diagnosis could help in specific management but this is rather challenging. Here we present a common presentation of an uncommon diagnosis. Case Presentation. A 47-year-old lady, previously well, presented to the outpatient clinic with intermittent left hypochondrial pain radiating towards left shoulder for 2 months not associated with fever, jaundice, or weight loss. Abdominal examination revealed nontender hepatosplenomegaly. The initial abdominal ultrasonogram (USG) was suggestive of a hydatid cyst, for which she received a course of antihelminthics. At follow-up, after finding no clinical improvement and radiological worsening, she underwent an exploratory laparotomy. A cyst replacing entire lower pole and a significant portion of splenic hilum was found. Total splenectomy was performed. The specimen was reported to be a SP. Conclusion. SP is a unique entity, usually misdiagnosed as a parasitic lesion and often treated with antihelminthic medicines. The natural course of disease, however, follows a subsequent failure of symptom resolution and radiological worsening that ultimately demands surgical attention. Based on size, location, and intraoperative findings, either total or partial splenectomy is required. The final histopathological report often presents a diagnostic surprise.