Laparoscopic surgical treatment of hepatic splenosis. A case report.

OBIETTIVO: La splenosi epatica isolata e una condizione rara ma possibile in chirurgia addominale. All’ imaging radiologico la splenosi epatica mima una neoplasia o una condizione patologica del fegato; ottenere una diagnosi certa prima dell’intervento chirurgico e difficile. Per questo motivo, i pazienti possono essere sottoposti ad operazioni inutili, con accesso laparotomico. CASE REPORT: A 31 years old man patient was admitted to our Institution because of upper chronic abdominal pain. Thirteen years before the recovery the patient was operated of splenectomy with laparotomic incision. Computerized Tomography and Magnetic Resonance demonstrated the presence of suspicious hepatic mass in the III segment. RISULTATI: La massa e stata asportata radicalmente con approccio laparoscopico. La degenza postoperatoria e stata buona e il paziente e stato dimesso sette giorni dopo l’operazione. L’esame istologico ha rilevato la presenza di tessuto splenico ectopico sulla superficie epatica ( splenosi). DISCUSSION AND CONCLUSION: Hepatic splenosis is not a rare condition and should be considered with the differential diagnosis especially in patients who had previous splenectomy and absence of liver cirrhosis. Laparoscopic exploration should always be preferred for the diagnosis of uncertain liver mass. Few works report laparoscopic excision for liver splenosis. For experience at our Institution laparoscopic procedure has an important role to get the diagnosis and it is also a feasible approach for minimally invasive resection. KEY WORDS: Laparoscopy, Liver, Splenosis.