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Persistent Left Sided Pleural Effusion Due to a Large Splenic Cyst - A Cross Compartment Trigger
Vivek Manchanda1, Nidhi Mahajan2, Natasha Gupta3
1Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Delhi, India.
The American Surgeon
|July 29, 2026
Summary
A splenic cyst in a child caused a persistent left-sided pleural effusion and respiratory failure. Prompt diagnosis and surgical removal of the splenic cyst resolved the effusion and improved respiratory status.
Area of Science:
- Pediatric Surgery
- Pulmonology
- Radiology
Background:
- Persistent pleural effusion with high output chest drainage can stem from extrathoracic causes.
- A 5-year-old girl presented with abdominal pain and shortness of breath, leading to respiratory failure.
Purpose of the Study:
- To highlight the importance of identifying intra-abdominal sources for persistent pleural effusions.
- To present a case of splenic cyst causing significant respiratory compromise in a child.
Main Methods:
- Case report detailing clinical presentation, diagnostic imaging (ultrasound, CT), and surgical intervention.
- Laparotomy for diagnostic and therapeutic purposes, followed by cystectomy with splenic preservation.
Main Results:
- A large splenic cyst (5.5 cm) and left-sided pleural effusion with septic emboli causing necrotizing pneumonia were identified.
- Post-cystectomy, intercostal drain output decreased, and the patient improved with antibiotics.
Conclusions:
- Splenic pathology can be an overlooked cause of pediatric pleural effusion and respiratory distress.
- Early identification of intra-abdominal sources is crucial for managing complex pleural effusions.
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