minocycline and Splenic-Diseases

The management of congenital splenic cysts continues to evolve. In the past the standard treatment was splenectomy, but increased knowledge about the spleen's immunologic function has led most pediatric surgeons to preserve splenic tissue. A great number of studies using sclerosing substances have been published, but to date reports in children have been limited. Our study concerns a group of 15 children with congenital splenic cysts treated with percutaneous drainage and sclerosis with alcohol. We performed the procedure under general anesthesia and checked radiologically for possible leakage.. In 2000 our group started managing pediatric patients with splenic cysts. During the first eight years surgery was the treatment of choice. From April 2008 to December 2014, a prospective study was conducted on 15 consecutive patients treated with percutaneous sclerotherapy. The outcomes regarding cystic dimensional variations before and after treatment were analyzed.. In 20% of patients complete disappearance of the cystic lesion was achieved. In 67% of the patients the maximum diameter of the cyst was reduced to below 50mm.. Our results should encourage the use of this treatment because it is a valid and safe option in childhood. The high success rate achieved with percutaneous drainage and sclerotherapy of cystic lesions supports our results.

Topics: Adolescent; Child; Cysts; Ethanol; Female; Follow-Up Studies; Humans; Male; Minocycline; Prospective Studies; Sclerosing Solutions; Sclerotherapy; Splenic Diseases; Treatment Outcome; Ultrasonography, Interventional

Solitary splenic cysts are relatively rare and usually asymptomatic. However, large ones sometimes show clinical manifestations. Non-surgical treatment of a solitary splenic cyst by instillation of minocycline chloride is described. Minocycline chloride was instilled into the splenic cyst through a pig-tail catheter indwelt under ultrasonographic guidance. Low concentration of minocycline chloride (200 mg diluted in 100 ml of saline) was not effective to reduce discharge from the splenic cyst. Discharged volume was markedly reduced after the instillation of high concentration of minocycline chloride (2000 mg diluted in 100 ml of saline). Eight weeks after this treatment, fluid discharge ceased. After 1 year, there was no findings of enlargement of the cyst. Ultrasonogram guided percutaneous instillation of minocycline chloride is a safe, easy, and useful procedure for treatment of a solitary and benign splenic cyst.

Topics: Aged; Aged, 80 and over; Cysts; Female; Humans; Minocycline; Splenic Diseases; Ultrasonography