Laparoscopic Treatment of the Symptomatic Splenic Implants in the Pelvis Minor

Overview

Objective:
The radical laparoscopic treatment of the aforementioned pathology has made it possible to eliminate recurrent pelvic pain of the 24 years old patient.Subject: Case report.Methods and results: 24 year old, nulligravid patient, had primary laparoscopy in 1998 because of chronic pelvic pain. Histology has confirmed both, the infiltrative endometriosis and the pelvic splenosis. While the endometriosis has been radically excised, splenic implants have been, in accordance with the current opinions in the literature, left in situ. Only their biopsy has been done. Due to recurrent pelvic pain after 15 months and the growth of the splenical implants, the second look laparoscopy was performed with the radical excision of these foci.Conclusion: The patient, 4 months after the intervention is asymptomatic. At variance with most of the literature, we assume that the pelvic splenosis in contrast to the abdominal is in many cases symptomatic. It causes especially pelvic pain and dyspareunia in connection with the contingent implant growth. In such cases the radical excision is indicated, where the laparoscopy is the chosen method. Authors are discussing the differentional diagnosis of this syndrome especially concerning endometriosis, peritoneal carcinomatosis, accessory spleen and the manifestation of the lymphoma.

Key words:
reccurent pelvic pain, infiltrative endometriosis, radical excision of foci, splenosis