Splenic Hydatid Cyst Disease: 15 Cases

Open Journal of Gastroenterology, 2014

Aim: Discuss the different modalities of surgical treatment of splenic hydatid cyst and outcomes after treatment. Patients and Methods: Retrospectively, 14 patients were operated in our institution between 2002 and 2011. Results: A total splenectomy was performed in 8 cases. A conservative treatment was preferred in 6 cases: 2 patients underwent partiel splenctomy and two patients underwent partial cystectomy. The duration of hospitalization ranged from 5 to 15 days. The morbidity rate was 14%. One patient presented a recurrent hemorrhage and one patient developed a left pneumonia. There is no death in our series. The mean duration follow-up was 20 months and there is no recurrence. Conclusion: Management of a splenic hydatid cyst is not consensual. Surgery remains the treatment of choice to avoid serious complications. Total splenectomy is optimal because it provides definitive treatment. However, spleen-preserving surgery is the preferred treatment in some selected patients.

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.

Jurnalul de Chirurgie

We performed a retrospective study of operated splenic hydatid cysts, in First Surgical Unit, "St. Spiridon" Hospital Iași, from 1990 until 2018. Clinical, laboratory, intraoperative and imagistic data were included in a MS Excel Office database. Statistical analysis was performed with the IBM SPSS Statistics ver. 20 for Windows. The statistical significance, the "p value" was considered p<0.05 (test t-Student and test Chi-Square). For establishing the mean we used Standard Error Mean. The aim of this study is to specify epidemiologic features, diagnostic tools, and therapeutic modalities of this disease. In the period 1990-2018 at the First Surgical Clinic of "St. Spiridon" University Hospital of Iasi 28 patients with splenic splenic hydatid cysts were operated by open or laparoscopic approach. Our retrospective study group included 16 women and 12 men with a mean age of 47.82 ± 2.47 years (ranges 19-70 years). Most patients were from rural areas (82.1%), the occupational hazards being frequently involved in etiopathogenesis of the disease (35.7%).

Digestive Surgery, 2003

Background: A hydatid cyst is still a serious health problem in endemic areas. Invasion of the spleen is rare in hydatid disease. In the medical literature, reports about isolated splenic hydatidoses are quite rare. Also there is not a consensus about the way of treatment. Methods: Between 1978 and 2000, in our clinic approximately 900 patients were operated on for an abdominal hydatidosis; 850 of these patients were treated for a hepatic hydatidosis and 14 patients for an isolated splenic hydatidosis. Six (42.8%) of the latter patients were male and 8 (57.1%) were female. The mean age of the patients was 47.14 B 4.9 (range 17-72) years. Ten patients (71.4%) presented with a painful mass in the left upper quadrant of the abdomen, and the other 4 patients (28.5%) were asymptomatic and were diagnosed incidentally. Results: All of the patients underwent elective splenectomy. There was no mortality, but complications occurred in 4 (28.5%) patients. The period of hospitalization ranged from 7 to 17 days with a mean of 9.8 days. 1 patient died from an acute myocardial infarction during the 2nd postoperative year, and 1 patient died as a consequence of a traffic accident during the 5th postoperative year. Nine patients, after follow-up periods of between 2 and 14 years, are living free from disease. No recurrence occurred in any of them. In the remaining 3 patients, long-term follow-up could not be maintained. Conclusions: A hydatid cyst must be included in the differential diagnosis of cystic lesions of the spleen. A splenic hydatid cyst should be treated surgically due to the high risk of a rupture, and the ideal procedure in adulthood is standard splenectomy.

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.

Indian Journal of Surgery, 2013

Hydatid disease is a parasitic infection caused by Echinococcus granulosus. Splenic involvement is rare even in endemic areas. The aim of this study is to specify epidemiologic features, diagnostic tools, and therapeutic modalities of this uncommon entity. This is a retrospective study of 21 patients operated on for a splenic hydatid cyst between January 1996 and December 2011. The mean age was 43.8 years (range 15-72 years). Sixteen patients (76.2 %) had symptoms related to a splenic location of hydatid disease. While splenic hydatid disease was solitary in 8 patients (38.1 %), other locations were present in 13 patients (61.9 %), mainly in the liver. Most splenic cysts were type I (39.3 %) or III (42.8 %). Nine patients (42.8 %) underwent resection of the protruding dome with one postoperative complication (suppuration of residual cavity). Total and partial splenectomies were performed in nine and three patients, respectively, without any complication. No death was noted. After a mean follow-up period of 36 months (range 2-108 months), no recurrence was observed. Splenic hydatid cyst is a rare location. The diagnostic is usually easy, based on serology and imaging. The surgery is the mainstay of treatment. The type of surgical procedure depends on size, number, and location of the cyst. Total splenectomy is more effective but may have high morbidity and mortality and must be reserved to specific situations. Conservative procedure is safer but could increase the rate of recurrence and postoperative collection. Puncture aspiration injection reaspiration could be proposed for small cyst in inoperable patients.

International journal of surgery case reports, 2016

Hydatid cyst is a common health problem of world in sheep grazing area. Liver is the most commonly involved organ. Splenic hydatid cyst is uncommon and its isolated involvement is very rare. We are presenting a case of isolated hydatid cyst of spleen in a sixty one year old female patient with complaints of pain in the left hypochondrium, dyspepsia and features of gastritis for the last 1 year. The diagnosis was confirmed by Contrast enhanced CT scan (CECT). Laparoscopic splenectomy was performed. The aim of this case report is to emphasize that the most important factor in diagnosing splenic hydatid cyst is the awareness of its possibility and the intraoperative precautions which will decrease morbidity and mortality in the postoperative period.

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.

Medicina

We present a case report that demonstrates diagnostic and intraoperative challenges in the laparoscopic management of initially unrecognized splenic hydatid disease. A male patient, aged 44, was admitted to our department with a big unilocular splenic cyst, radiologically (ultrasonography, computed tomography) characterized as a simple cyst. Serological tests for anti-Echonococcus antibody were negative, and chests X-ray findings were unremarkable, so laparoscopic cyst fenestration with omentoplasty was planned. The intraoperative finding did not correspond to a simple splenic cyst. Hydatid daughter cysts were recognized after the careful opening of the cyst wall. The operation was completed without shifting to open procedures. Laparoscopic partial pericystectomy with omentoplasty is a safe and effective surgical procedure for the management of splenic hydatid disease.

The hydatid cyst of the spleen results from the development of the hydatid worm Echinococcus granulosus, in the splenic parenchyma. Humans are the accidental intermediate host in the development cycle of hydatid disease. Splenic involvement is the third most common location after the liver and lung. Echography and sometimes tomography are needed to confirm the diagnosis. In the absence of truly effective medical treatment, splenic hydatidosis often leads to surgery. Resection of the protruding dome is the treatment of choice due to low morbidity and absence of mortality. We report the case of 27 years old, with no particular medico-surgical history, referred to our hospital for the treatment of a splenic hydatid cyst discovered fortuitously during a radiological assessment. The patient was operated by laparoscopy. The treatment consisted of sterilization of the contents of the cyst with hydrogen peroxide, removal of the contents and resection of the salient dome, the results were unremarkable.