Grand rounds and Teaching Files - Pediatric Oncall
Splenectomy without Prior Vaccination

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Ira Shah
Consultant in Pediatric Infectious Diseases and Pediatric Hepatology, Nanavati Hospital and Incharge Pediatric HIV, TB and Liver Clinics, B J Wadia Hospital for Children, Mumbai, India.

Address for Correspondence: Dr Ira Shah, 1, B Saguna, 271, B St Francis Road, Vile Parle {W}, Mumbai 400056.

Clinical Problem:
A 9 years old boy presented with pain in left part of abdomen since days. There was no fever or trauma. On examination, vital parameters were normal. There was firm splenomegaly. Other systems were normal. Investigations showed hemoglobin of 10.8 gm, dl, white cell count of 9,400, cumm {with platelets of 2,49,000, cumm. Ultrasound abdomen showed 12.6 x 10.4 x 9.4 large hypoechoic area with internal echoes in the spleen. CT abdomen showed 12.8 x 9 cm hypodense homogenous lesion with lobulated margins suggestive of large splenic abscess. At the time of surgery, it was diagnosed to be a cyst and histopathology proved it to be an epidermoid cyst of spleen. The child is asymptomatic on follow up.

When to do splenectomy in splenic cysts_? How to vaccinate in emergency splenectomy_?

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