Abstract

Splenic cysts are rare, and many are asymptomatic and are found incidentally. We report an interesting case of a young diabetic with ketoacidosis who was found to have an incidental large splenic cyst mimicking the clinical picture of diabetic gastroparesis.

A 31-year-old white male with type 1 diabetes mellitus presented with nausea, vomiting, diarrhea and upper abdominal pain of 5 days’ duration. His past medical history was significant for multiple hospitalizations for diabetic ketoacidosis secondary to medical noncompliance. In addition, 2 months before admission he was involved in a motor vehicle collision. He had denied symptoms of persistent nausea or vomiting before this admission. On physical examination, he was found to be lethargic with a BP of 100/82 mm Hg and a pulse rate of 108/m. The patient was tachypneic with a respiratory rate of 24/min and was afebrile. Abdominal examination was unremarkable except for tenderness in the epigastrium and both hypochondrial regions. Stool examination was heme negative.