Giant spleen as a surgical challenge - case report and literature review

Introduction According to the guidelines of the European Association of Endoscopic Surgery, any case where the maximum craniocaudal splenic diameter exceeds 20 cm is considered massive splenomegaly. In addition to metabolic, hematological, and hemodynamic problems, enlarged spleen may cause mechanical difficulties due to the pressure to surrounding organs and vascular structures. The aim of this paper is to present the surgical challenges and technique applied in massive splenomegaly, in a patient who had neglected the importance of regular medical checkups. Case outline We present a 62-year- old male patient who was admitted to hospital for treatment of previously clinically and radiologically verified splenomegaly but who neglected the importance of regular checkups and medical treatment. Splenectomy was performed with a splenic specimen 38 cm in its maximal diameter. Conclusion Taking into consideration all the possible benefits and possible complications of surgical treatment, including the quality of life of splenectomized patients, comprehensive preoperative assessment should be made, and surgical treatment selectively applied.