Surgery in children with hydatid disease of the spleen

World Journal of Laparoscopic Surgery with DVD, 2021

Aim: Aim of reporting this case is to show the feasibility and outcomes of laparoscopic splenectomy in hydatid disease of spleen. Background: Hydatid cyst is a zoonotic disease and it can affect humans. It can involve any organ; liver is the most common organ to involve, and in rare cases spleen could also be involved. Isolated splenic involvement is even rarer. Management is splenectomy. Laparoscopic splenectomy is feasible if uncontrolled spill is avoidable. Here we are presenting a case of laparoscopic splenectomy in an isolated splenic hydatid cyst. Case description: A 41 years old lady presented with left upper abdominal Pain for six months. There was no chest or other abdominal complaints. Examination revealed a palpable spleen. Ultrasonography abdomen, contrast-enhanced computed tomography, and hydatid serology help to diagnose splenic hydatid, cystic echinococcosis type. Vaccination and perioperative albendazole were administered. She underwent laparoscopic splenectomy. Standard steps were followed to prevent spillage. The specimen was delivered through Pfannenstiel incision. Cut-section demonstrated hydatid membranes. Conclusion: Isolated splenic hydatid is rare and rarely managed laparoscopically. It should be practiced when expertise available. Clinical significance: Rare entity of isolated splenic hydatid cyst could be treated by laparoscopic method without causing any perioperative spill or complications and preserve all benefits of laparoscopic surgery in presence of expertise.

Digestive Diseases and Sciences, 2002

The aims of this study were to investigate the efficacy of a new percutaneous treatment of hydatid cysts of the spleen and to present the results of long-term follow-up. Nine patients (six men, three women; median age 37 years) with 10 hydatid cysts in the spleen underwent a new percutaneous treatment. The procedure included the puncture and free drainage of the cyst fluid under sonographic guidance. After drainage has stopped, alcohol 96% and polidocanol 1% were used as sclerosing agents. The patients were followed up with periodic sonographic examinations. The median follow-up period was 39 months (range: 6–64 months). The median diameter of the cysts decreased from 63.0 mm to 33.3 mm (P < 0.01). The entire cyst cavity filled with a solid echo pattern in three cysts, two thirds of the cyst cavity showed a pseudotumor pattern in three cysts, and one third of the cyst cavity showed a pseudotumor pattern in four cysts. Apart from an urticarial reaction, no major complications occurred during the follow-up period. One patient had under-gone splenectomy due to persistent left upper quadrant pain eight months after treatment. Long-term results indicate that this new treatment modality of splenic hydatidosis is an effective and safe method and causes no major complications.

The Eurasian Journal of Medicine

Objective: Cystic echinococcosis (CE) is rarely encountered in the spleen, even in areas where the disease is endemic. There is no consensus in the literature concerning the treatment of splenic cystic echinococcosis. This study was intended to compare the treatment results and factors affecting the selection of the spleenpreserving approach or splenectomy in treatment. Materials and Methods: Four hundred and seventy patients operated for cystic echinococcosis at a university clinic between January 2010 and December 2019 were retrospectively evaluated. Splenic cystic echinococcosis was identified in 22 patients (4.7%). Demographic features as well as clinical and laboratory findings of patients who underwent splenectomy or spleen-preserving operations were compared between the groups. Results: Spleen-preserving cystotomy was performed on 18 patients (81.8%), and splenectomy on 4 (18.2%). Eleven patients (50%) had isolated cystic echinococcosis in the spleen, while another 11 (50%) had hepatic and splenic cystic echinococcosis. The median cyst size was 10.0 cm (min: 3, max: 20). Splenectomy patients had significantly larger cyst sizes (median, min-max; 8.0 cm, 3-15 cm vs. 15.0 cm, 10-20) (Z = 2.071, P = .042). Postoperatively, 1 patient from the splenectomy group (25.0%) developed deep vein thrombosis, and another from the cystotomy group (5.5%) developed pulmonary embolism. No other serious complications, re-operation requirements, or recurrence were observed after a median follow-up period of 27.0 months (min: 5, max: 92). Conclusion: Since no collections or recurrence were observed, and splenic functions were preserved in patients who underwent spleen-preserving cystotomy, we recommend the use of spleen-protective cystotomy. Splenectomy should be employed in patients with cyst diameters exceeding 10 cm, with a central location, and in cases with difficult cavity management and a high risk of developing postoperative collections.

Primary hydatid disease of spleen is rare. We report here is a case of 40 year old male presenting with pain in the left hypochondrium at JARASH Hospital on 4/9/2014. The patient gave history of long standing splenic cyst. Then CT Scan was done & revealed cystic swelling within the spleen suggestive of hydatid Cyst. So splenectomy was done and spleen was sent for histopathological examination which confirmed the diagnosis.

Seminars in Ultrasound, CT and MRI, 2007

Journal of Gastrointestinal Surgery, 2013

Background The aim of this study was to discuss the management of patients with splenic hydatid cyst (SHC) and to provide a review of the literature in this field. Methods The outcomes of patients surgically treated for SHC at the Diyarbakir Education and Research Hospital (DERH) between January 2006 and May 2013 were assessed by retrospectively reviewing demographic, radiological, and clinical data. In addition, the outcome profiles of these patients were compared to the overall outcomes of surgically treated SHC cases reported in the literature. Relevant case series (≥4 cases) were identified by searching the PubMed, Medline, and Google Scholar databases for publications from 1990 to May 2013 in English or Turkish languages. Results Nine patients with SHC received surgical treatment at DERH (age range, 18-53 years old; mean, 36.9±11.8; female/ male, 7/2), including five (55.6 %) primary SHC and four (44.4 %) secondary (100 % liver) SHC cases. Two patients had previous SHC surgery. Seven patients received albendazole therapy, both preoperative (10-21 days) and postoperative (10-42 days) periods. All patients received vaccination, either preoperative (n =4) or postoperative (n =5). Six patients underwent splenectomy and three underwent splenectomy with partial cystectomy and omentopexy, and no patient experienced SHC recurrence during follow-up (1-60 months). The literature review identified 27 full-text articles representing 333 surgically treated SHC cases, among which 60.5 % had primary SHC and 39.5 % had secondary SHC. Two hundred thirty of 333 patients underwent splenectomy, 81 underwent spleen-sparing surgery, and 17 underwent puncture, aspiration, injection, and reaspiration. The remaining five patients were not operated for various reasons. Conclusion We found no significant difference in recurrence rates between splenectomy and spleen-sparing surgery, either in our patient cohort or among cases reported in the literature. Nevertheless, we cannot make any solid recommendations for either procedure based on these results, as the studies were largely retrospective.

Annals of medicine and surgery, 2021

Introduction: Hydatid disease is endemic in farming areas but occurs worldwide. The most common site of disease is liver. Hydatid disease of the spleen is a rare condition. Worldwide incidence of splenic hydatid is 0.5-4%. Surgery is the mainstay of treatment. The standard treatment is open total or partial splenectomy. Presentation of case: A 28 year-old female patient was referred to our institution, after coincidental sonography finding. On abdominal examination, there was no sensitization, and there was no resistance or rebound. Ultrasound showed an enlarge spleen; an abdominal CT confirmed the presence of a splenic cyst at the lower pole of the spleen of 7 cm in diameter, no other organ involvement. The biological confirmation was made by indirect hemagglutination. Spleen-sparing surgery was performed. Macroscopic and microscopic examination of the specimen confirmed Hydatid cyst. The patient was discharged from hospital on the seventh postoperative day with a prescription for albendazole (2 × 400 mg/day) for three months. Discussion and conclusion: The rarity of primary splenic hydatid disease poses a diagnostic challenge for clinicians, the disease should be considered in differential in every patient in endemic areas with cystic lesion of spleen until proved otherwise, it may be detected incidentally or present with non-specific complaints, preservation surgery should always be tried to avoid post splenectomy infection, especially in young patients.

International Surgery, 2013

The benefits and risks of surgery for splenic hydatid cyst (SHC) remain controversial. We aimed to share our experience about a surgical approach for SHC. Sixteen consecutive patients with SHC disease who underwent open splenectomy at our hospital between January 2006 and July 2012 were retrospectively evaluated. Data on the patients&#39; demographic features, clinical findings, radiological and serological diagnostic methods, and surgical and medicinal treatment options were collected and used to generate descriptive profiles of diagnosis, treatment course, and outcome. The patient population was composed of 6 females and 10 males, with an age range of 18 to 79 years (mean age: 47.0 ± 18.0). Radiological examinations detected hydatid cysts in spleen alone (n = 7) or both spleen and liver (n = 9). Preoperative serological testing identified 13 of the patients as IHA positive. All except 1 patient received a 10- to 21-day preoperative course of albendazole therapy and all patients re...

Acta Parasitologica, 2008

The spleen is a rare location for hydatid cysts with the larvae reaching the site after escaping the hepatic and pulmonary filters. For most surgeons, splenectomy is the primary treatment in such cases which aims at eradicating the disease while decreasing the chances of recurrence by removing the intact cyst. While this is true, the risks of other two parasitic infections are increased, namely malaria and babesiosis. In the case presented here, the spleen was preserved after extirpating the cyst to keep the patient's immunity against malaria, which is endemic in our region.

The Korean Journal of Parasitology, 2012

Cystic disease of the spleen is an uncommon entity in general population. Most cases result from parasitic infection by Echinococcus granulosus, a form called splenic hydatid disease (SHD), with a reported frequency of 0.5-6.0% within abdominal hydatidosis. On the contrary, an isolated splenic involvement of hydatid disease is very uncommon even in endemic regions. Two cases of primary SHD managed with open and laparoscopic radical surgery in our department are reported herein. Primary SHD is a rare entity with non-specific symptoms underlying clinical suspicion by the physician for prompt diagnosis. Surgical treatment is the mainstay therapy, while laparoscopic approach when feasible is safe, offering the advantages of laparoscopic surgery.

Cases Journal, 2009

We present a case of multiple hydatidosis in an 8-year-old boy that resulted from a ruptured hydatid cyst of the spleen and spread into the peritoneal cavity. We also present a new approach for managing these difficult and high-risk cases.

The Egyptian Journal of Hospital Medicine

Background: Cystic Echinococcosis (CE) is one of the most prevalent important neglected zoonotic diseases caused by the larval form of the tapeworm, Echinococcus granulosus, and it represents a significant public health threat in many Mediterranean countries like Egypt. Human acts as the accidental intermediate host where the larval stage, hydatid cyst is formed. While liver and lung constitute the most commonly involved sites for primary cysts, other organs are occasionally affected. Primary hydatid cysts of the spleen are rarely present. Patients and methods: This study reported an uncommon case of multiple primary hydatid cysts of the spleen in a 55year-old man presented with pain in the left hypochondrium. A history of close contact with dogs was reported. The initial diagnosis was based on the abdominal ultrasonography and confirmed by the computed tomography (CT) scan and the serological detection using indirect hemagglutination test (IHAT) in the clinic. Results: The ultrasonography and CT scan revealed subcapsular hydatid cyst in the spleen with peripheral small daughter cysts. Serologically, hydatid cyst positive patient serum was recorded at 1:1280 titer by IHAT. Total splenectomy was successfully done, and the patient was discharged and prescribed with a prophylactic albendazole. Conclusions: ultrasonography, computerized tomography and serology are useful diagnostic tools for hydatidosis and the disease is considered a public health challenge and needs accurate differential diagnosis from any cystic mass/s in the abdomen.

International Journal of Integrative Medical Sciences, 2016

Hydatid cyst disease is a zoonotic infection with Echinococcus sp as the causative agent. Man is an accidental dead end host. It can affect any organ of body most common being the liver. Primary infection of spleen is rare. Treatment modalities include medical, surgical and combined.

Journal of Gastrointestinal Surgery, 2012

Aim We analyzed the outcomes and effectiveness of surgical treatments and clinical manifestations of splenic hydatid cysts. Patients and Methods Between 2000 and 2011, we retrospectively reviewed the cases of 11 patients who were operated on for a splenic hydatid cyst. The demographic features, medical history, physical examinations, biochemical and serological tests, imaging modalities, and surgical treatment of the patients were noted. Results The mean patient age was 36.45 years (range, 20-66 years). While isolated splenic hydatid disease was present in five patients, other abdominal hydatid cysts were accompanied by a splenic hydatid cyst in six patients. Left upper abdominal pain was present in seven (64%) patients, whereas four (36%) patients were asymptomatic. Eight patients (72.72%) had undergone a total splenectomy and three (27.28%) had undergone spleen-preserving surgery. Postoperative complications developed in four (36%) patients at 5-15 days postoperatively. Conclusion Management of a splenic hydatid cyst is not consensual. Total splenectomy is optimal because it provides definitive treatment. However, spleen-preserving surgery is the preferred treatment in selected patients. The choice of technique depends on the localization, number, and size of hydatid cysts, and the absence or presence of other hydatic organ cysts.