Management of Nonparasitic Splenic Cysts

Nonparasitic splenic cysts represent a rare subset of benign splenic lesions, classified by the absence of parasitic infection and the presence or absence of an epithelial lining. Management strategies centre upon balancing symptom relief, avoidance of recurrence and preservation of splenic immune function. Small asymptomatic cysts under 5 cm are often managed conservatively with imaging surveillance, whereas symptomatic, large or complicated lesions warrant intervention. Minimally invasive approaches have evolved as the preferred first-line treatment, with laparoscopic cyst fenestration and partial splenectomy each offering reductions in hospital stay and postoperative discomfort. Cyst aspiration combined with sclerotherapy may be considered in selected cases, though concerns over recurrence and leakage persist. Total splenectomy, once the mainstay, is now reserved for extensive or recurrent cysts when parenchymal preservation is not feasible. Advances in fluorescence imaging and intraoperative guidance have further refined the delineation of vascular anatomy, enhancing the safety of spleen-preserving resections. A multidisciplinary approach, incorporating radiological expertise, surgical innovation and tailored follow-up protocols, is essential to optimise outcomes and mitigate risks such as overwhelming post-splenectomy infection.

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Management of Nonparasitic Splenic Cysts publication trend

The graph below shows the total number of articles in management of nonparasitic splenic cysts across all publications each year (not limited to Nature Index journals).

Technical terms

Nonparasitic splenic cyst: benign fluid-filled lesion of the spleen arising without parasitic infection.

Total splenectomy: surgical removal of the entire spleen, eliminating risk of cyst recurrence but carrying immunological consequences.

Partial splenectomy: resection of the cyst-bearing segment of splenic tissue to preserve residual function.

Cyst fenestration: surgical creation of an opening in the cyst wall to allow continuous drainage into the peritoneal cavity.

Cyst aspiration: percutaneous or intraoperative suction of cyst contents, often combined with sclerosing agents.

Pseudocyst: cavity lacking epithelial lining, typically arising after trauma or degeneration.

Laparoscopy: minimally invasive technique employing small incisions and a camera for intra-abdominal surgery.

References

1. A Giant Non-Traumatic Splenic Pseudocyst Successfully Treated With Cyst Aspiration and Partial Cystectomy: A Case Report and Review of Literature. Cureus (2024).
2. Laparoscopic Approach to Primary Splenic Cyst: Case Report and Review of the Literature. Life (2024).
3. Surgical treatment of benign splenic lesions in pediatric patients: a case series of 30 cases from a single center. BMC Surgery (2022).
4. Laparoscopic Partial Splenectomy Assisted by Fluorescence in a 13-Year-Old Girl. European Journal of Pediatric Surgery Reports (2020).