RESUMO
INTRODUCTION AND IMPORTANCE: The falciform ligament is a peritoneal fold that extends from the anterior abdominal wall to the liver, which divides the liver into two lobes. Cysts of the falciform ligament are rare and without an apparent cause. The range of the symptoms can vary from abdominal pain to asymptomatic patients. Cysts are treated surgically, and resection is used to make a definitive diagnosis. CASE PRESENTATION: A 36-year-old female patient was treated at an outpatient facility for epigastric pain that lasted for three months. Abdominal MRI and MSCT were performed to verify a cyst formation in the left liver area of about 12 cm in size. Laparoscopic resection of the cist was performed under general endotracheal anaesthesia. CLINICAL DISCUSSION: Falciform ligament tumours can be malignant or benign. Treatment of the cyst includes complete excision and pathohistological diagnosis to rule out malignancy. In most cases reported thus far, excision has been done after laparotomy. In our case, the operation was performed in a less invasive way, laparoscopically. CONCLUSION: Laparoscopy can serve as a diagnostic and therapeutic method for cysts of the falciform ligament, both smaller and more significant, that infiltrate the surrounding structures.
RESUMO
Echinococcal cyst of the spleen is usually a result of infection with the parasite Echinococcus granulosus. The spleen is the third most frequent localization of echinococcus after liver and lungs. Partial laparoscopic pericystectomy can be done without the loss of blood and scattering of scolexes with spleen preservation and conservation of its immune function. We present the patient with a large (1 8 x 16 x 12 cm) echinococcal cyst of the spleen that compressed the surrounding organs (stomach, transverse colon, pancreas and left kidney), and prevented normal passage causing vomiting after every meal. In this patient, PAIR procedure (puncture, aspiration, injection, reaspiration) and conservative treatment was attempted on several occasions without success. Finally, laparoscopic partial pericystectomy was performed, evacuating the contents of the cyst. The surgery lasted 120 minutes. Postoperatively the patient was without complications. Hospitalization lasted five days. Six months later, the patient is without problems. These echinococcus cysts of the spleen cannot be solved using PAIR technique and conservative treatment. Laparoscopic partial pericystectomy is a better solution than open surgery due to less trauma to the patient, especially in elderly people.
