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Massive splenic cyst in pregnancy: case report

BACKGROUND: Primary splenic cysts are very rarely diagnosed in pregnancy, with only thirteen cases described in the literature. We examine the approach towards diagnosing and managing uniquely large abdominal masses that significantly complicate obstetric care. CASE PRESENTATION: A 37-year-old primi...

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Autores principales: Chung, Philip, Swinson, Ben, O’Rourke, Nicholas, Schmidt, Bart
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201964/
https://www.ncbi.nlm.nih.gov/pubmed/32375702
http://dx.doi.org/10.1186/s12884-020-02968-y
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author Chung, Philip
Swinson, Ben
O’Rourke, Nicholas
Schmidt, Bart
author_facet Chung, Philip
Swinson, Ben
O’Rourke, Nicholas
Schmidt, Bart
author_sort Chung, Philip
collection PubMed
description BACKGROUND: Primary splenic cysts are very rarely diagnosed in pregnancy, with only thirteen cases described in the literature. We examine the approach towards diagnosing and managing uniquely large abdominal masses that significantly complicate obstetric care. CASE PRESENTATION: A 37-year-old primigravida woman presented with abdominal distension and discomfort, yet otherwise asymptomatic. On ultrasound, an incidental pregnancy at 25 weeks of gestation and a large pelvic lesion were discovered. MRI defined a 28 × 29 cm lobulated, complex cystic mass in the upper abdomen. The patient underwent two ascitic drainages throughout her pregnancy. At 34 weeks of gestation, she had a classical caesarean section. Then at five-weeks postpartum, she underwent a laparotomy and total splenectomy with 16 L of fluid drained. Histopathological analysis revealed an epithelial cyst of the spleen. Her recovery was complicated by complete portal vein thrombosis. CONCLUSION: This case describes the largest splenic cyst ever reported in pregnancy and explores the diagnostic dilemmas and treatment challenges associated. We introduce the utility of serial ascitic drainages in prolonging the pregnancy and emphasise the reliance on imaging for surveillance of splenic size and fetal wellbeing.
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spelling pubmed-72019642020-05-09 Massive splenic cyst in pregnancy: case report Chung, Philip Swinson, Ben O’Rourke, Nicholas Schmidt, Bart BMC Pregnancy Childbirth Case Report BACKGROUND: Primary splenic cysts are very rarely diagnosed in pregnancy, with only thirteen cases described in the literature. We examine the approach towards diagnosing and managing uniquely large abdominal masses that significantly complicate obstetric care. CASE PRESENTATION: A 37-year-old primigravida woman presented with abdominal distension and discomfort, yet otherwise asymptomatic. On ultrasound, an incidental pregnancy at 25 weeks of gestation and a large pelvic lesion were discovered. MRI defined a 28 × 29 cm lobulated, complex cystic mass in the upper abdomen. The patient underwent two ascitic drainages throughout her pregnancy. At 34 weeks of gestation, she had a classical caesarean section. Then at five-weeks postpartum, she underwent a laparotomy and total splenectomy with 16 L of fluid drained. Histopathological analysis revealed an epithelial cyst of the spleen. Her recovery was complicated by complete portal vein thrombosis. CONCLUSION: This case describes the largest splenic cyst ever reported in pregnancy and explores the diagnostic dilemmas and treatment challenges associated. We introduce the utility of serial ascitic drainages in prolonging the pregnancy and emphasise the reliance on imaging for surveillance of splenic size and fetal wellbeing. BioMed Central 2020-05-06 /pmc/articles/PMC7201964/ /pubmed/32375702 http://dx.doi.org/10.1186/s12884-020-02968-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Chung, Philip
Swinson, Ben
O’Rourke, Nicholas
Schmidt, Bart
Massive splenic cyst in pregnancy: case report
title Massive splenic cyst in pregnancy: case report
title_full Massive splenic cyst in pregnancy: case report
title_fullStr Massive splenic cyst in pregnancy: case report
title_full_unstemmed Massive splenic cyst in pregnancy: case report
title_short Massive splenic cyst in pregnancy: case report
title_sort massive splenic cyst in pregnancy: case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201964/
https://www.ncbi.nlm.nih.gov/pubmed/32375702
http://dx.doi.org/10.1186/s12884-020-02968-y
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