A CASE OF SPONTANEOUS RUPTURE OF AN EPIDERMOID CYST OF THE SPLEEN

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 66; no. 8; pp. 2004 - 2007
• Main Authors: KATO, Koichi, KANAZUMI, Naohito, ITO, Fujio, SUZUKI, Yuichi, KIMURA, Jiro, ISHII, Masataka
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2005
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.66.2004

We report a rare case of spontaneous rupture of an epidermoid cyst of the spleen causing acute abdomen. A 29-year-old woman without history of abdominal trauma was seen at the emergency clinic in the hospital because of severe abdominal pain extending from the region of the epigastric fossa to the entire abdomen as well as vomiting. There were tenderness and Blumberg's sign in the entire abdomen. Abdominal CT scan showed a large cyst and some small cysts in the spleen and a large amount of ascites. Peritoneal puncture yielded brown muddy ascites. Acute panperitonitis due to spontaneous rupture of the splenic cyst was diagnosed and emergency surgery was performed. At laparotomy, multiple cysts in varying size were seen in the spleen and a 10-cm cyst of them had ruptured and a large amount of brown fluid collection was found. We considered that conservation of the spleen was impossible and performed a splenectomy and drainage. The postoperative course was uneventful. Histopathological findings showed a single to several layers of flattened cells lined partially in the wall of the splenic cyst. The definitive diagnosis was epidermoid cyst of the spleen.