Dirk Schaper, P. Göbel (Kinderchirurgie St. Barbara-Krankenhaus Halle/S.)  

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14 Years  

Female  

Abdomen-Spleen  

congenital  

The first presentation of the then 9 year-old girl was based upon unspecific lower abdominal pain. Chance findings in the routine sonographic examination. Initially, the findings were just watched, with follow-ups every quarter year. As the findings were found to increase in size at the age of 13, ultrasound aspiration was done and a short-term drainage was performed. An instillation of a locally acting substance was performed. In the follow-up examination, the structures decreased in size. After 6 months, however, a renewed increase in size was noted and a renewed aspiration was performed. Since the pathological findings remained, a surgical treatment was performed.  

N/A  

<- view Ultrasound 1

Ultrasound 1: Presentation of the pathological findings in the left upper abdominal quadrant. Multicystic structure, which moves well with breathing.




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Ultrasound 2: Presentation of the spleen as a neighboring organ.




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Ultrasound 3: Doppler sonographic vascularization




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OP-Situs 1: Surgical findings




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OP-Situs 2: Surgical findings




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OP-Situs 3: Surgical findings

 

Surgery / Histo  

Posttraumatic splenic cyst, dermoid cyst, cystic hemangioma, parasitic cyst  

After the initially performed aspiration without success, the surgical treatment and resection of the splenic lymphangioma was opted. A sufficiently large splenic rest could be saved.
All in all, a splenic lymphangioma is a very seldom illness. Aside from the casuistics in children, isolated splenic lymphangiomas are described mostly in adults. A lymphangiomatosis, which is described often in literature, could not be found in our patient.  

In the experience we gathered in this case, the multicystic changes of the spleen could no longer be treated with aspiration-instillation. This is usually shown to be helpful in solitary splenic cysts.
In childhood, we feel that the resection with saving the spleen was the method of choice.  

N/A  

1. Medline:
Morgenstern L, Bello JM, Fisher BL, Verham RP
The clinical spectrum of lymphangiomas and lymphangiomatosis of the spleen.
Am Surg. 1992 Oct;58(10):599-604

2. Medline:
Wolters U, Keller HW, Lorenz R, Pichlmaier H.
Splenic cysts: indications for surgery and surgical procedures
Langenbecks Arch Chir. 1990;375(4):231-4.  

Splenic, lymphangioma, spleen, treatment, splenic lymphangioma, child, childhood, pediatric radiology  

Dirk Schaper, P Göbel. Splenic Lymphangioma. PedRad [serial online] vol 4, no. 4.
URL: www.PedRad.info/?search=20040414134304