Cysts, tumors and abscesses of the spleen Flashcards Preview

Cameron's Esophagus and Spleen > Cysts, tumors and abscesses of the spleen > Flashcards

Flashcards in Cysts, tumors and abscesses of the spleen Deck (30):
1

What percentage of splenic cysts are parasitic?

5%

2

Most common parasitic organism found in splenic cysts

Echinococcus granulosus

3

Treatment of parasitic splenic cysts

Medical management followed by splenectomy

4

CT appearance of nonparasitic splenic cysts

Solitary cyst with occasional wall calcifications

5

Accounts for 90% of all nonparacystic cysts

Epidermoid cysts

6

Etiology of most secondary splenic cysts or pseudocysts

Trauma

7

When is surgical intervention indicated for splenic cysts?

Size greater than 5 cm, or symptomatic

8

Why can noninfectious cysts less than 5 cm be managed nonoperatively?

Often resolve on their own

9

Surgical options for intervention for splenic cysts

unroofing cyst, complete or partial splenectomy or fenestration

10

How much spleen must remain to preserve splenic function?

25%

11

Most common malignancy involving the spleen?

Non Hodgkin's lymphoma

12

Does splenectomy affect survival in NHL

No. There is no increase in survival

13

What percentage of patients with stage I or II Hodgkin's lymphoma have splenic disease?

Up to 35%

14

What benefit does splenectomy give patients with CLL?

No increase in survival, but reduction in transfusion requirements, and lowers lymphocyte count.

15

What is the role of splenectomy in myelofibrosis?

Plays a palliative role, reducing transfusion requirements and improving quality of life. Myelofibrosis is universally fatal, with a mean survival of 5 years.

16

Cancers known to metastasize to the spleen

Breast, Lung, Melanoma, Ovarian/Endometrial, Gastric, Colonic and prostate

17

What percentage of patients with NHL have splenic involvement?

40%

18

Most common benign tumor of the spleen

Hemangioma

19

Risks of splenic hemagiomas

Rupture and hemorrhage

20

Splenic lymphangiomas are associated with similar lesions in what other locations?

lymphangiomas of the liver, lung, skin and bone

21

Treatment of malignant splenic lesions

Splenectomy

22

When do benign splenic tumors require surgical treatment?

To alleviate symptoms or confirm a diagnosis

23

Causes of splenic abscess?

Hematogenous spread from distant primary septic focus (endocarditis, intraabdominal infections, pyelonephritis), IV drug use, or secondary after trauma.

24

Most common cultured bacteria in splenic abscesses

Staphylococcus and Streptococcus

25

What organisms are more common in immunocompromised individuals with splenic abscesses?

Candida and Aspergillosis (8%).

26

What is the definitive treatment for splenic abscesses?

Splenectomy

27

What are the failure rates in percutaneous drainage of splenic abscesses?

50-60%

28

If unable to administer vaccinations prior to surgery, when should they be given post splenectomy?

2 weeks post splenectomy

29

When is inicidence of OPSS highest postoperatively?

One year post splenectomy

30

What is advocated for the first one to two years post splenectomy in high risk patients?

Prophylactic antibiotics (ususally pencilliins)