Splenic Hydatid Cysts: 17 Cases

Abstract

Hydatid cyst disease, which is endemically observed and an important health problem in our country, involves the spleen at a frequency ranking third following the liver and the lungs. In this study, we aimed to evaluate the efficacy and results of management in splenic hydatid cysts. The demographic data, localization, diagnosis, treatment methods, and the length of postoperative hospital stay of patients with splenic hydatid cysts in a 12-year period were evaluated retrospectively. Seventeen cases were evaluated. Among these, 13 were females and four were males. Seven had solitary splenic involvement, eight had involvement of both the spleen and the liver, and two had multiple organ involvement. Ten had undergone splenectomy, one had undergone distal splenectomy, and the remaining cases had undergone different surgical procedures. The patients had received albendazole treatment in the pre-and postoperative period. One patient had died secondary to hypernatremia on the first postoperative day. The clinical picture in splenic hydatid cysts, which is seen rarely, is usually asymptomatic. The diagnosis is established by ultrasonography and abdominal CT. Although splenectomy is the standard mode of treatment, spleen-preserving methods may be used.

Surgical Approach to Splenic Hydatid Cyst: Single Center Experience

“…1,2 Currently, estimates of the worldwide incidence of this disease range from 0.5 to 8.0%, accounting for 0.5 to 4.0% of all abdominal echinococcosis cases reported. [1][2][3]7,9,12 However, these studies have failed to definitely determine whether primary or secondary cases are more common (with wide ranges of incidence rates being reported; primary: 38.1-80.0%, secondary: 16.0-61.9%), [1][2][3]5,[8][9][10]12 or whether solitary or multiple lesions are more common (solitary: 41.1-94.7%, multiple: 5.3-33.0%). 1,2,4,6,[8][9][10] It is possible that these disease characteristics are affected by yet unknown geographic, behavioral, environmental, or other many factors.…”

“…1,3 SHC have a very slow growth pattern (0.3-2.0 cm/y), which allows patients to remain completely asymptomatic for decades. [1][2][3][4][7][8][9][10][11][12] As such, diagnosis is often made incidentally during clinical investigation of other ailments, and especially during radiological tests performed for liver cysts. 1,2,4,9,11 However, among the symptomatic cases, the majority of symptoms are nonspecific, 4,9 with the most common being abdominal pain and/or bloating, constipation (due to colonic compression), and dyspnea (due to left diaphragmatic compression).…”

“…1,2 For both asymptomatic and symptomatic cases, the most common findings in physical examination are mass in the left upper quadrant (31.2-71.4% of cases) and splenomegaly (12.5-35.3% of cases). [8][9][10][11] It has been suggested that the development of symptoms may be triggered by the following cyst-related complica- tions: infection, opening into adjacent hollow organs, rupture into the pleural or peritoneal cavity, hypersplenism, anaphylactic shock, and cysto-pleural fistula formation. [1][2][3]9 However, none of the 16 patients in the current study had signs of any of these complications that may have explained their presenting symptoms.…”

“…Diagnosis and differential diagnosis of SHC can be easily accomplished by combined use of radiological and serological testing. 1,3,5,9,10 US and CT are the most commonly used radiological tests for hydatid cyst diagnosis, and it is known that the radiological appearance of these cysts depends upon the cyst location, patient age, and presence of complications (rupture or secondary infection). 1,3 The 2 tests provide complimentary data for design-ing clinical management strategies; for example, US (a noninvasive, sensitive, and cost-effective technique) is useful for cyst staging 1,3,10 while CT more accurately detects cyst number, size, localization, and presence of cysts in other organs.…”

“…Key words: Spleen -Splenic hydatid cyst -Splenectomy -Clinical experience -Diagnosis -Outcome H ydatid disease, also known as echinococcosis, is caused by the Echinococcus parasites belonging to the Taeniidae family of the Cestode class. [1][2][3][4][5][6][7][8][9][10][11][12] While 4 of these parasitic species are known human pathogens, the most commonly diagnosed are E. granulosus, which causes cystic echinococcosis (known as hydatid cysts) and E. alveolaris, which causes alveolar echinococcosis. 1 However, humans are considered incidental hosts of the parasites, and infection is established upon oral ingestion of materials contaminated with fecal matter containing Echinococcus eggs from the primary hosts (dogs and other canids) or direct contact with dogs.…”