Primary Splenic Hydatidosis
selin kapan2003, Digestive Surgery
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Abstract
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.
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Surgical treatment and outcomes of hydatid cyst of the spleen
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.
Primary splenic hydatid cyst an unexpected diagnosis: Case report
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.
Selecting a Surgical Modality to Treat a Splenic Hydatid Cyst: Total Splenectomy or Spleen-Saving Surgery?
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.
Surgical Approach to Splenic Hydatid Cyst: Single Center Experience
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' 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...
A case of spleen hydatid cyst
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.
Hydatid Disease of the Spleen: Single-Center Experience and a Brief Literature Review
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.
Surgery in children with hydatid disease of the spleen
Journal of Pediatric Surgery, 2006
A giant splenic hydatid cyst
Proceedings (Baylor University. Medical Center), 2016
A 16-year-old girl presented with pain in the left hypochondrium, which had been progressing for 5 months. Examination revealed large splenomegaly, and ultrasonography showed a huge hydatid cyst in the spleen. Preoperative planning and postoperative care lead to successful management of this entity. Radiological investigations also play a major role in diagnosis and decrease morbidity.
A New Therapeutic Approach for Treatment of Hydatid Cysts of the Spleen
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.
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Isolated hydatid cyst of spleen: A rare case with rare presentation
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.
A Retrospective Evaluation of Spleen Hydatid Cyst Treatments: The Spleen-Preserving Conservative Approach is Preferable to Splenectomy
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.
Laparoscopic Management of Hydatid Cyst of Spleen: A Rare Case Report
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.
PRIMARY HYDATID CYST OF THE SPLEEN
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.
Splenic hydatid cyst: is splenectomy necessary?
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.
Hydatid Cyst of the Spleen: Tunisian Series of 21 Cases
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.
SPLENIC HYDATID CYST DISEASE: 15 CASES.
Hydatid cyst disease is endemic in our country. The splenic involvement comes at the third rank following the liver and the lungs. 15 cases were evaluated, retrospectively, between 2002 and 2013. The gender distribution was 73% Females and 27% males. The mean age is 48 years. The pain was a frequent reason for consultation (40%). Splenomegaly was found in 46,7% of patients. The diagnosis is established by Ultrasound scan and computed tomography scan. The splenic hydatid cyst was solitary in 6 cases. Surgical treatment was performed in all cases. Deroofing was the most common method in 53%of cases, and total splenectomy in 47% of cases. The results were good with no mortality and morbidity consisting of one sub-phrenic abscess that required external drainage.
Two Cases of Primary Splenic Hydatid Cyst in Greece
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.
Giant Isolated Hydatid Cyst of Spleen
Journal of spleen and liver research, 2015
Liver is most commonly involved organ in hydatid cyst. Primary splenic hydatid cysts are rare; we report a case of an isolated giant hydatid cyst of spleen in a 17-year-old man. The diagnosis was confirmed by imaging findings and serology. Partial cystectomy was performed with success. In cystic lesions of spleen, hydatid cyst should be kept in patrician's mind in the differential diagnosis. Although splenectomy is the gold standard for treating hydatid disease of the spleen, in young patient spleen-preserving surgery seems give good results.
Splenic epithelial cyst mistaken with Hydatid cyst: A case report
International Journal of Surgery Case Reports
Introduction: Cystic lesions of the spleen are infrequent and usually diagnosed incidentally. These lesions are rare and their differential diagnosis is very wide. Splenic epithelial cysts are the most common type of primary splenic cyst (4%). Surgical treatment is indicated for cysts larger than 5 cm or symptomatic. Nowadays, spleen preserving surgery is the gold standard treatment considering the immunologic role of the spleen and the increased risk of post-splenectomy infections. Case presentation: A 17 year old girl presented to the outpatient clinic with moderate left upper quadrant abdominal pain of 2 weeks duration with loss of appetite and denied fever, chills, sweating and jaundice. Abdominal examination showed tender splenomegaly. The abdominal imaging (Ultrasound, CT SCAN, MRI) was suggestive of hydatid cyst of the spleen, for which she received Albendazole for 1 month and then operated by laparotomy with partial resection and un-roofing of the splenic cyst. The pathology report showed a splenic epithelial cyst (SEC). Conclusion: SEC is a rare pathology that could mimic splenic hydatid cyst. The clinical and radiological pictures may be commonly misleading and non-conclusive. Definitive diagnosis is made on histopathology. Spleen conserving surgery, when possible, is the preferred modality for treatment.
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