Splenic Hydatid Cyst Research Articles

A Splenic Hydatid Cyst Case Presented with Lumbar Pain

A splenic hydatid cyst is a rare clinical entity from among abdominal hydatid cysts, even in endemic countries. Here, a case with lumbar pain due to a giant splenic hydatid cyst is presented. The importance of this case is that the patient presented at the clinic with only lumbar pain. Initial direct abdominal plain radiography showed a giant abdominal calcification in the spleen and further examinations revealed involvement of three organs: spleen, lung, and liver.

A rare case: Spontaneous cutaneous fistula of infected splenic hydatid cyst

Hydatid disease is caused by the larval stage of the genus Echinococcus. Live hydatid cysts can rupture into physiologic channels, free body cavities or adjacent organs. Although hydatid disease can develop anywhere in the human body, the liver is the most frequently involved organ, followed by the lungs. Cysts of the spleen are unusual. There are only five case reports of spontaneous cutaneous fistulization of liver hydatid cysts in the literature. But there isn't any report about cutaneous fistula caused by splenic hydatid cyst. We report a first case of spontaneous cutaneous fistula of infected splenic hydatid cyst. A 43-year-old man was admitted to our Emergency Service with abdominal pain and fluid drainage from the abdominal wall. He has been suffering from a reddish swelling on the abdominal wall skin for four months. After a white membrane had been protruded out from his abdominal wall, he was admitted to our Emergency Service. On physical examination, a white membrane was seen to protrude out from the 2 cm x 1 cm skin defect on the left superolateral site of the umblicus. Large, complex, cystic and solid mass of 9.5 cm-diameter was located in the spleen on ultrasonographic examination. At operation, partial cystectomy and drainage was performed. After the operation, he was given a dosage of 10 mg/kg per day of albendazole, divided into three doses. He was discharged on the postoperative 10(th) d. It should be kept in mind that splenic hydatid cysts can cause such a rare complication.

Experience with Benign Splenic Disease

Purpose : In the ongoing effort to improve patient treatment, a deeper understanding of the symptomatology, physical signs and management options of rare splenic, non-traumatic, benign diseases is extremely important. Patients and Methods : The records of eight consecutive patients with benign splenic conditions, other than injury and abscess, were reviewed retrospectively in order to analyse the clinical presentation, diagnostic methodology and therapeutic procedures applied in these rare conditions.Of the eight patients, three were diagnosed with splenic hydatid cyst, two with pseudocysts, one with splenic epider-moid cyst, one with wandering spleen and one with infraction of an ectopic spleen with situs inversus of other intraabdominal organs.Results : Upper abdominal pain was the most common presenting symptom and a tender palpable mass in the left upper abdominal quadrant, the predominant clinical finding. Pre-operative CT scanning confirmed the diagnosis in six patients, but failed to reveal the splenic pathology in the remaining two cases. Seven patients underwent splenectomy while saving splenic parenchyma was feasible in only one patient (12,5%).Conclusions : Splenic, non-traumatic, benign diseases have vague clinical presentation and may create diagnostic difficulties. Although spleen saving intervention can be applied in selected cases, splenectomy would be required in most patients.

Unusual localizations of hydatid disease.

Hydatid disease is endemic in several Mediterranean countries, posing an important health problem for these countries. The hydatid cyst is characterized by cystic lesions with clear boundaries, which can be observed in all parts of the body. Approximately 70 % of hydatid cysts are situated in the liver, followed by the lung (25 %). The kidneys, spleen, bile ducts, mesentery, soft tissue and brain are less frequent sites. We investigated patients who were treated for hydatid disease in our departments in the last 5 years with respect to localization of the disease, symptoms, surgical intervention, length of hospitalization, diameters of the cyst, and classification by Gharbi. In this retrospective and descriptive study, 176 patients are evaluated who were treated for hydatid disease between 1995 and 1999 in our departments. Of these patients, 14 were included with localization other than in the liver and lungs. Fourteen of the patients diagnosed with unusually located hydatid disease were men, six were women. Their mean age was 41.6 +/- 20.8 years; the length of hospital stay was 7.07 +/- 0.4 days. Overall, 28.6 % of patients with unusually located hydatid cyst had recurrent disease. The time period since last cyst operation was 5.25 +/- 3.5 years. The mean cyst diameter was 96.5 +/- 54.5 mm. According to Gharbi's classification, three cases (21.4 %) of the unusually located hydatid cysts were type I, two (14.3 %) type II, and eight (57.1 %) type III. There was only one case of type IV and no cases of type V. Spleen and kidneys are the organs where hydatid disease is most frequently observed after the liver and lung. It can be observed in all parts of the body including the brain, peritoneum, mesenterium, choledochus, pancreas, bone and muscles. The type of treatment is determined by the localization and type of hydatid disease. Surgical treatment for splenic hydatid cysts is splenectomy. The functional kidney should be saved in non-communicable hydatid disease. Total excision is almost never possible; endocystectomy and drainage procedure should be preferred for hydatid disease of the brain, pancreas and choledochus. Chemotherapy is usually given because of the risk of recurrence; this medical treatment consists in albendazole and mebendazole administration for 3-6 months in the postoperative period.

Primary Splenic Hydatidosis

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 ± 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.

Surgical management of splenic hydatidosis.

This study was conducted to evaluate the surgical management of splenic hydatidosis in an area where the disease is endemic. Over a period of 16 years, 26 patients with splenic hydatidosis underwent surgery in our department. Preoperative investigations included plain abdominal X-ray, serology, ultrasonography, and computed tomography. In our series, splenic hydatidosis represented 3.5% of total abdominal hydatidosis. The majority of patients presented with abdominal discomfort and palpable swelling in the left hypochondrium. Twenty-two patients were operated on electively and 4 as emergency cases, including 2 with ruptured hydatids and 2 with infected hydatids of the spleen. Isolated splenic hydatid cysts were present in 21 patients, associated liver hydatid cysts in 4, and diffuse abdominal hydatidosis in 1 patient. All patients underwent splenectomy except for one patient who initially had partial splenectomy for a lower polar cyst. This patient also ended up undergoing a splenectomy for postoperative hemorrhage. One patient died on the sixth postoperative day (mortality rate 3.8%) as a result of multiorgan failure, and 4 developed minor complications (morbidity 15.4%). Splenic hydatidosis, although rare, is the third most common type of hydatidosis after liver and lung hydatidosis. This entity should thus be kept in mind when encountering a splenic cyst especially in areas where the disease is endemic. A splenectomy remains the treatment of choice because it demonstrates low morbidity and mortality rates.

Surgical Treatment for Splenic Hydatidosis

Splenic involvement is rare in patients with hydatid disease even in endemic countries. The spleen is the third most commonly involved organ after the liver and the lung. In our series splenic echinococcosis represents 5.8% of abdominal hydatid disease. During the last 22 years, 14 patients were operated on for splenic hydatid cysts in our department. In 10 patients the spleen was the only location of hydatid disease; in 2 patients there was concomitant liver hydatid disease; one patient had disseminated intraabdominal disease; and one patient had a coexisting hydatid cyst in the quadriceps femoris muscle. Plain abdominal films, ultrasonography, and computed tomography scans were most useful for establishing the diagnosis. All patients underwent splenectomy alone or combined with management of cysts at other sites, except for two patients who underwent omentoplasty and one patient who underwent external drainage. One patient died during the early postoperative period (mortality rate 7%), and three patients had minor complications. Splenic hydatid disease should be included in the differential diagnosis when a splenic cyst is identified, especially in patients with a history of hydatid disease. Surgery remains the treatment of choice to avoid serious complications.

Splenothoracic fistula complicating primary splenic hydatidosis

Splenothoracic fistula complicating primary splenic hydatidosis

Conservative surgery for splenic hydatid cyst

Splenectomy has been the treatment of choice for hydatid cyst of the spleen. By successful enucleation of a deepseated splenic hydatid cyst and preservation of the spleen, the authors show the technical feasibility of such a procedure and recommend it as the treatment of choice.

Hydatid Disease of the Spleen

Seven patients with hydatid disease of the spleen were examined by radiography, ultrasound, CT, and in one case MR imaging. The observations were confirmed by patho-anatomic findings except in 2 patients where high indirect hemagglutination tests confirmed the diagnosis. In one patient primary, and in the others secondary, echinococcosis of the spleen was assumed to be present. Secondary hydatid disease of the spleen was caused by rupture of liver cysts with abdominal and pelvic dissemination. Ultrasound and CT findings of the cysts and cystic calcifications are described. In one patient MR imaging indicated prolapse of a splenic hydatid cyst into the left hemithorax, confirmed by patho-anatomic examination.

Hydatid disease of the spleen

Seven patients with hydatid disease of the spleen were examined by radiography, ultrasound, CT, and in one case MR imaging. the observations were confirmed by patho-anatomic findings except in 2 patients where high indirect hemagglutination tests confirmed the diagnosis. in one patient primary, and in the others secondary, echinococcosis of the spleen was assumed to be present. Secondary hydatid disease of the spleen was caused by rupture of liver cysts with abdominal and pelvic dissemination. Ultrasound and CT findings of the cysts and cystic calcifications are described. in one patient MR imaging indicated prolapse of a splenic hydatid cyst into the left hemithorax, confirmed by patho-anatomic examination

Abscessed splenic hydatid cyst: Sonographic and ct findings

Splenic hydatid cyst abscess formation is extremely rare. We present a surgically proved case of abscessed hydatid cyst of the spleen with its appearance on sonography and computed tomography (CT). Although both imaging methods do not confirm a diagnosis of abscessed splenic hydatidosis, they are valuable examinations to support the diagnosis and define the extent of disease. Percutaneous drainage of splenic abscessed lesions must be avoided when hydatid disease is suspected.