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Guo Q, Liu H, Wang G. Ruptured splenic hydatid cyst. Heliyon 2024; 10:e33701. [PMID: 39040308 PMCID: PMC11261087 DOI: 10.1016/j.heliyon.2024.e33701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/13/2024] [Accepted: 06/25/2024] [Indexed: 07/24/2024] Open
Abstract
Hydatid cysts of the spleen are rare. Our report details a case wherein an 8-year-old boy with a ruptured splenic hydatid cyst suffered ongoing abdominal pain and shock. Computed Tomography (CT) imaging showed an irregular cyst at the spleen's lower edge with a "floating membranes" sign. Emergency surgery was performed to remove the hydatid cyst and repair the ruptured spleen. During follow-up, the patient was treated with Albendazole orally for 12 months.
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Affiliation(s)
- Qiang Guo
- Department of Radiology, The First People's Hospital of Kashi Prefecture, Kashi Prefecture, Xinjiang Uygur Autonomous Region, 844000, China
| | - Huajin Liu
- Department of Radiology, The First People's Hospital of Kashi Prefecture, Kashi Prefecture, Xinjiang Uygur Autonomous Region, 844000, China
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, 51900, China
| | - Guojie Wang
- Department of Radiology, The First People's Hospital of Kashi Prefecture, Kashi Prefecture, Xinjiang Uygur Autonomous Region, 844000, China
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, 51900, China
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2
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Koirala DP, Yadav M, Shah NA, Yadav D, Neupane S, Yadav C. Giant isolated splenic hydatid cyst in a pediatric patient: A rare case report. Int J Surg Case Rep 2024; 120:109768. [PMID: 38805842 PMCID: PMC11150960 DOI: 10.1016/j.ijscr.2024.109768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/30/2024] Open
Abstract
INTRODUCTION Hydatidosis, caused by Echinococcus granulosus, is endemic in regions where cattle rearing is prevalent. While liver and lung involvement are common, isolated splenic hydatid cysts are rare, particularly among adolescents. We present a rare case of a 14-year-old female with an isolated giant splenic hydatid cyst. CASE PRESENTATION A 14-year-old female presented with left upper quadrant pain. Imaging revealed a large splenic cyst without evidence of liver or lung involvement. A total splenectomy was performed, and a histological examination confirmed the diagnosis of a hydatid cyst. The patient underwent postoperative albendazole therapy and remained asymptomatic during follow-up. CLINICAL DISCUSSION Isolated splenic hydatid cysts are rare in the pediatric population. Imaging techniques such as ultrasound and CT play a crucial role in diagnosis. Surgical resection and Puncture-aspiration-injection-reaspiration remain the choice of treatment, supplemented by anti-parasitic therapy. Postoperative follow-up is essential to monitor for recurrence. CONCLUSION Isolated splenic hydatid cysts are exceptionally rare in pediatric patients. Prompt diagnosis, surgical intervention, and postoperative surveillance are crucial for successful management and prevention of recurrence.
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Affiliation(s)
| | - Manish Yadav
- Institute of Medicine, Tribhuvan University, Nepal.
| | | | - Digraj Yadav
- Institute of Medicine, Tribhuvan University, Nepal
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3
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Mulpuri TC, Rajan YR, Sajja J, Gogineni SRS, Veerapaneni SSA. A Case Series of Isolated Primary Hydatid Cyst of the Spleen. Cureus 2024; 16:e62252. [PMID: 39006671 PMCID: PMC11245048 DOI: 10.7759/cureus.62252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 07/16/2024] Open
Abstract
Hydatid disease is endemic mainly in Asia and other sheep-raising areas. In India, hydatid disease has been a very common disease because of its close association with livestock rearing. Hydatid disease is a parasitic infestation caused by Echinococcus granulosus. The usual location of infestation is in the liver sinusoids, lungs, and spleen. Hydatid disease in humans is rare, and a hydatid cyst of the spleen without involving the liver is very rare. The rarity of splenic hydatid disease may pose a diagnostic challenge for clinicians, especially in non-endemic areas. The diagnosis of hydatid disease is based on the epidemiological background of patients, clinical grounds, or noninvasive screening procedures. With this background, we aimed to study the presenting symptomatology and various clinical manifestations of isolated spleen hydatid disease and analyze the morbidity and mortality of hydatid disease. Different surgical modalities and their complications were studied. Three patients operated on for splenic hydatid at our institute were studied retrospectively.
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Affiliation(s)
- Tarun C Mulpuri
- General Surgery, Siddhartha Medical College, Vijayawada, IND
| | | | - Joshua Sajja
- General Medicine, Siddhartha Medical College, Vijayawada, IND
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4
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Bhatnagar R, Hingway S, Chatterjee PB. A Stellar Case of Splenic Hydatid Cyst. Cureus 2024; 16:e63372. [PMID: 39070331 PMCID: PMC11283769 DOI: 10.7759/cureus.63372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
Hydatid disease, also known as hydatidosis or echinococcosis, is a zoonotic infection caused by cestode, namely Echinococcus granulosus (tapeworm). Humans are the incidental hosts that acquire the infection by being in contact with infected animals or through the fecal-oral route via contaminated feces. Hydatid disease of the spleen is a zoonotic disease of rare occurrence. Most often, the patients do not have any specific symptoms except dull dragging pain in the abdomen. In some unfortunate cases, the patient may present with an acute abdomen or anaphylactic shock state due to rupture of the cyst, which is a medical and surgical emergency. The mainstay of treatment remains albendazole and praziquantel medically, along with surgery, i.e., splenectomy. A 30-year-old female presented in the OPD with complaints of pain in the abdomen for the last two years with no other complaints. The pain did not respond to regular analgesics and antacids. The patient was admitted for further evaluation. A contrast-enhanced computed tomography (CECT) abdomen was done for the patient, which showed splenomegaly along with features suggestive of a splenic hydatid cyst. The lady was taken for a planned splenectomy. The histopathological features were suggestive of a hydatid cyst of the spleen. The mainstay of treatment is medically anthelmintic medications and surgical splenectomy along with the puncture aspiration injection re-aspiration (PAIR) technique.
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Affiliation(s)
- Rishika Bhatnagar
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Snehlata Hingway
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Priya B Chatterjee
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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5
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Khan F, Reddy H, Negandhi PK, Javvaji CK, Kumar S. Splenic Hydatid Cyst Presenting As Non-cirrhotic Portal Hypertension: A Rare Case Report. Cureus 2024; 16:e60025. [PMID: 38854266 PMCID: PMC11162825 DOI: 10.7759/cureus.60025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 05/10/2024] [Indexed: 06/11/2024] Open
Abstract
Hydatid cystic disease, also called cystic echinococcosis, arises from Echinococcus, a tapeworm infestation. It results in developing cysts primarily in the liver, although they can also occur in other organs. While the spleen is an uncommon site for cyst formation, it can still be affected. These infections are more prevalent in rural and underdeveloped regions, particularly among individuals involved in livestock rearing and animal care. The case we came across was of a 32-year-old female from a rural background engaged in animal handling and farming. She presented to our hospital with left hypochondriac pain, decreased appetite, and generalized weakness, but the patient had a history of two episodes of melena, which was self-limiting. Subsequent investigations revealed a diagnosis of splenic hydatid cyst with perisplenic collaterals and cystic compression of the splenic vein, causing symptoms of non-cirrhotic portal hypertension. Here, we present a unique case of splenic hydatid cyst leading to non-cirrhotic portal hypertension. This rare presentation poses diagnostic challenges and emphasizes the importance of considering parasitic infections in differential diagnoses.
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Affiliation(s)
- Faizanulla Khan
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Harshitha Reddy
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Priyanka K Negandhi
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Chaitanya Kumar Javvaji
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sunil Kumar
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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6
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Makhoul E, Harb M, Makhoul S. Primary hydatid cyst of the spleen: A rare case report and literature review. Arab J Gastroenterol 2024; 25:230-233. [PMID: 38238228 DOI: 10.1016/j.ajg.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/28/2023] [Accepted: 11/11/2023] [Indexed: 06/03/2024]
Abstract
Hydatidosis is an endemic disease in certain areas in the world particularly in the Mediterranean, the Middle East, and South America, caused by a cestode known as Echinococcus granulosus. Humans are the accidental intermediate hosts. The liver and the lungs are the most commonly involved organ. If the parasite passes through the pulmonary capillary bed, the hydatid cyst may develop at any site in the body like bone, pancreas, brain, kidney, and orbit. Isolated spleen hydatid cyst is very rare. We hereby report one observation of isolated hydatid cyst of the spleen in a patient living in non-endemic area and without any potential risk.
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Affiliation(s)
- Elias Makhoul
- Department of Gastroenterology, University Hospital Notre Dame de Secours, Byblos, Lebanon; School of Medicine and Sciences Medical Holy Spirit University of Kaslik, Lebanon; Pole of Gastroenterology, Polyclinic du Parc Maubeuge, France.
| | - Marc Harb
- Department of Gastroenterology, University Hospital Notre Dame de Secours, Byblos, Lebanon; School of Medicine and Sciences Medical Holy Spirit University of Kaslik, Lebanon; Pole of Gastroenterology, Polyclinic du Parc Maubeuge, France
| | - Selim Makhoul
- Department of Gastroenterology, University Hospital Notre Dame de Secours, Byblos, Lebanon; School of Medicine and Sciences Medical Holy Spirit University of Kaslik, Lebanon; Pole of Gastroenterology, Polyclinic du Parc Maubeuge, France
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7
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Ashraf A, Mittal R. Postpartum Spontaneous Rupture of a Primary Splenic Hydatid Cyst: A Case Report. IRANIAN JOURNAL OF PARASITOLOGY 2024; 19:260-266. [PMID: 39011530 PMCID: PMC11246208 DOI: 10.18502/ijpa.v19i2.15862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/01/2024] [Indexed: 07/17/2024]
Abstract
Hydatid disease is endemic in some regions of the world. Even in endemic regions, splenic hydatid cysts are rare, especially in pregnancy. The most serious presentation is intra peritoneal rupture, which is a surgical emergency. Exploration with splenectomy is the favoured management. We present a case of splenic hydatid cyst, detected late in pregnancy, with intraperitoneal rupture in the postpartum period. Cystic lesions located anywhere in the body in endemic regions could be hydatid cysts. Prompt treatment should be planned immediately on detection in order to prevent potentially serious complications like rupture.
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Affiliation(s)
- Aabid Ashraf
- Department of General Surgery, Gulf Asian Medical Center, Al Jubail, Saudi Arabia
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8
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Vantankhah A, Ameri L, Bahrami Taqanaki P, Bayat MJ, Parvizi Mashhadi M. A 16-year-old adolescent with a history of minor abdominal trauma diagnosed with a giant isolated primary splenic hydatid cyst: a case report. Ann Med Surg (Lond) 2024; 86:2292-2295. [PMID: 38576966 PMCID: PMC10990299 DOI: 10.1097/ms9.0000000000001851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 02/11/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Hydatosis is a zoonotic parasitic disease caused by echinococcosis larval infection. South America, Africa, the Middle East, South Europe, India, and Australia are endemic to this disease. Splenic involvement is a rare and complicated hydatid disease presentation. A splenic hydatid cyst is an infrequent clinical occurrence, even in regions where the disease is endemic. Case presentation A 16-year-old male, having a background of mild abdominal trauma and non-resolving dull abdominal pain attended a paediatric surgical outpatient office and following a thorough examination, was diagnosed with a giant solitary isolated splenic hydatid cyst. Subsequently, the patient received albendazole and underwent total splenectomy, necessitated by the considerable size of the cyst, classified as a giant. Clinical discussion Splenic involvement of hydatid disease is a rare presentation (0.5-8%.). With the initial clinical finding often involving the accidental discovery of a palpable mass, the most frequently reported symptoms and signs include the presence of a palpable mass, fever, dull pain, or splenomegaly. Ultrasound and computed tomography are the most helpful tools for evaluating focal splenic diseases. The preferred treatment involves the use of antihelminthic drugs such as albendazole or mebendazole in conjunction with splenectomy. Total splenectomy is the preferred approach and is associated with decreased hospital stay, reduced healthcare costs, and a lower likelihood of recurrence. Conclusion in endemic areas, in patients with splenic cysts, hydatidosis should be contemplated.
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Bouhout T, Majdoubi A, Abdelbassir R, Serji B. Spleen-preserving surgery for splenic hydatid cyst: a case report. Pan Afr Med J 2024; 47:139. [PMID: 38881767 PMCID: PMC11178669 DOI: 10.11604/pamj.2024.47.139.43008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 03/16/2024] [Indexed: 06/18/2024] Open
Abstract
Hydatidosis is a zoonosis due to the development of the larval form of Echinococcus granulosus in humans. This disease is very frequent in many countries of North Africa such as Morocco. The most frequent locations of hydatid cysts are the liver (75%) and the lungs (15.4%). Splenic hydatid cyst occurs in only 5.1% of cases. The diagnosis remains challenging and is made upon a hundle of clinical, radiological, biological, and histological arguments. In this paper, we report a case of spleen-preserving surgery for a splenic hydatid cyst to suggest the best management of these hydatid cysts and avoid recurrences.
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Affiliation(s)
- Tariq Bouhout
- Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco
| | - Amine Majdoubi
- Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco
| | - Ramdani Abdelbassir
- Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco
| | - Badr Serji
- Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco
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Yadav S. Pre-extensively Drug-Resistant Pulmonary Tuberculosis With a Giant Primary Splenic Hydatid Cyst With Multiple Adverse Drug Reactions. Cureus 2024; 16:e55722. [PMID: 38586676 PMCID: PMC10998647 DOI: 10.7759/cureus.55722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/09/2024] Open
Abstract
Drug-resistant tuberculosis is a noteworthy threat to public health, especially in high-burden countries. Management of these types of tuberculosis is lengthy and associated with a number of adverse drug reactions. Pre-extensively drug-resistant tuberculosis is a serious type of disease that is caused by the strains of Mycobacterium tuberculosis that are resistant to either rifampicin or both, i.e., rifampicin and isoniazid, and resistant to any fluoroquinolones. A splenic hydatid cyst is relatively rare and has never been reported in a case of pre-extensively drug-resistant pulmonary tuberculosis. The present case is a rare case of a young Indian male who was diagnosed with pre-extensively drug-resistant pulmonary tuberculosis through a cartridge-based nucleic acid amplification test and second-line drug susceptibility testing. Further, a diagnostic radiometric investigation showed a giant hydatid cyst in the spleen. He was started on an all-oral longer treatment regimen per the existing protocols. However, his treatment was associated with multiple adverse drug reactions.
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Affiliation(s)
- Sankalp Yadav
- Medicine, Shri Madan Lal Khurana Chest Clinic, New Delhi, IND
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11
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Mihetiu A, Bratu DG, Tanasescu C, Vintilă BI, Sandu A, Sandu M, Serban D, Sabau D, Hasegan A. Laparoscopic Management of Multiple Liver, Omental, Mesenteric, Peritoneal, and Round Ligament Hydatid Cysts-A Rare Report of a Case and a Systematic Literature Review. J Pers Med 2024; 14:205. [PMID: 38392638 PMCID: PMC10890065 DOI: 10.3390/jpm14020205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
Hydatid cyst disease is a parasitic ailment with an endemic nature, predominantly affecting geographical areas with a tradition in animal husbandry. The most common localization of hydatid disease is in the liver (60%), followed by the lungs, with other organ localizations comprising less than 10%. The surgical approach to this condition can be carried out through open surgery or laparoscopy. The coexistence of hepatic and intraperitoneal hydatidosis often leads to the preference for open surgery. We performed a literature review aiming to retrieve data regarding demographic characteristics, clinical features, preoperative management, and surgical approach concerning these unusual localizations of hydatid disease. It was observed that the mesenteric localization frequently presented with acute abdominal pain (p = 0.038) and that the open approach was preferred in 85.71% of cases. Furthermore, an interdependence was identified between the localization of the cysts and the type of surgical approach (p = 0.001), with mesenteric localizations being approached through laparotomy and excision (p = 0.037), while omental localizations, due to the easier approach, benefited from laparoscopy with excision in 14.29% of cases. Overall, the laparoscopic approach was less frequently used, but its utilization resulted in a lower number of complications and faster recovery. Additionally, we present a rare case of hepatic and intra-abdominal hydatidosis, resolved exclusively through a laparoscopic approach, including a review of the literature for these uncommon localizations of hydatid disease. A 45-year-old patient diagnosed with multiple hydatid cysts, both hepatic and intraperitoneal, underwent surgical intervention with exploratory laparoscopy. Laparoscopic excision of peritoneal, epiploic, mesenteric cysts, and round ligament, along with laparoscopic inactivation, evacuation, and pericystectomy of hepatic hydatid cysts, was performed. The patient's recovery was uneventful, and she was reevaluated at 3 and 9 months without signs of recurrence. The association of hepatic hydatid cysts with multiple intra-abdominal localizations is not commonly encountered. The treatment of choice is surgical and is predominantly conducted through open surgery. The presented case is unique due to the exclusive laparoscopic approach in the management of mixed hepatic and intra-abdominal hydatidosis.
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Affiliation(s)
- Alin Mihetiu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Dan Georgian Bratu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Ciprian Tanasescu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Bogdan Ioan Vintilă
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Alexandra Sandu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Mariana Sandu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Dragos Serban
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania
| | - Dan Sabau
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Adrian Hasegan
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
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Genamo E, Bejiga G, Neda K, Bato A, Metekia H. A rare simultaneous occurrence of splenic and ovarian hydatid cyst: A case report. Int J Surg Case Rep 2024; 115:109296. [PMID: 38266365 PMCID: PMC10818067 DOI: 10.1016/j.ijscr.2024.109296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Hydatid disease is an infectious illness caused by a parasite called Echinococcus. It can affect any organ, primarily the liver and lungs. The occurrence of splenic or ovarian hydatid cyst is rare; simultaneous involvement of both is extremely uncommon. This case report provides valuable insights to clinicians, guiding them to consider a hydatid cyst as a potential differential diagnosis in the presence of a cystic mass lesion. CASE PRESENTATION A 33-year-old female presented with abdominal pain of 10 years duration. The past medical and surgical history was negative. Ultrasound and CT scans of the abdomen showed double-layered splenic (15.3 cm × 12.8 cm × 15 cm) and pelvic (8.4 cm × 10.3 cm × 9 cm) cysts. Laparotomy revealed splenic and ovarian hydatid cysts with adhesions to surrounding structures. We performed total splenectomy and left salphingo-opherectomy, yielding excellent outcome. DISCUSSION Hydatid cysts of the spleen and ovary are rare, with few case reports. It is usually secondary to systemic dissemination or intra-peritoneal spread from a ruptured hepatic cyst. Imaging modalities such as ultrasound and CT scans can aid in reaching a diagnosis. The standard treatment for a hydatid cyst is surgery. CONCLUSION The simultaneous occurrence of hydatid cysts in the spleen and ovary is rare. The diagnosis is challenging due to nonspecific clinical presentations, necessitating a high level of suspicion. Surgery is the primary treatment for hydatid cysts.
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Affiliation(s)
- Endris Genamo
- Department of Surgery, Loke Siraro Hospital, Siraro, Ethiopia.
| | - Gosa Bejiga
- Adama Hospital Medical College, Adama, Ethiopia
| | - Ketema Neda
- Department of Surgery, Dodola General Hospital, Dodola, Ethiopia
| | - Abdisa Bato
- Department of Gynecology and Obstetrics, Dodola General Hospital, Dodola, Ethiopia
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Patil M, Gharde P, Reddy K. Lung Hydatidosis Unveiled: A Multisystem Mirage of Pathological Rarity. Cureus 2024; 16:e52819. [PMID: 38406156 PMCID: PMC10883861 DOI: 10.7759/cureus.52819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Lung hydatidosis is a zoonotic infection, primarily caused by Echinococcus sp., and has a significant role in the economy and public health. Canines are the predominant hosts of these parasitic tapeworms. Lungs are the most commonly infected organ after the liver. Hepatic pulmonary blood circulation is mainly reported to transport infection to the lungs. The prevalence of hydatid disease has increased over the past decade. In addition, patients with multi-organ involvement of hydatid cysts have been reported in different parts of the world. Hydatidosis can remain asymptomatic for years after infection in some conditions, especially in cases of splenic hydatidosis. Chest radiography and computed tomography findings can be used to confirm the diagnosis of hydatid disease. Hydatid disease is, in general, managed by pharmacological therapy, but if multi-organ involvement is observed, surgery along with medical management is required. Long-term follow-up is recommended in such cases to check the recurrence of the disease.
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Affiliation(s)
- Mihir Patil
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pankaj Gharde
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Kavyanjali Reddy
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Sadr S, Lotfalizadeh N, Abbasi AM, Soleymani N, Hajjafari A, Roohbaksh Amooli Moghadam E, Borji H. Challenges and Prospective of Enhancing Hydatid Cyst Chemotherapy by Nanotechnology and the Future of Nanobiosensors for Diagnosis. Trop Med Infect Dis 2023; 8:494. [PMID: 37999613 PMCID: PMC10674171 DOI: 10.3390/tropicalmed8110494] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023] Open
Abstract
Hydatid cysts have been widely recognized for decades as a common medical problem that affects millions of people. A revolution in medical treatment may be on the prospect of nanotechnology enhancing chemotherapy against hydatid cysts. An overview of nanotechnology's impact on chemotherapeutics is presented in the current review. It discusses some of the challenges as well as some of the opportunities. The application of nanotechnology to enhance chemotherapy against hydatid cysts is what this review will explore. Nanotechnology is a critical component of delivering therapeutic agents with greater precision and efficiency and targeting hydatid cysts with better efficacy, and minimizing interference with surrounding tissue. However, there are biodistribution challenges, toxicity, and resistance problems associated with nanotherapeutics. Additionally, nanobiosensors are being investigated to enable the early diagnosis of hydatid cysts. A nanobiosensor can detect hydatid cysts by catching them early, non-invasively, rapidly, and accurately. The sensitivity and specificity of diagnostic tests can be enhanced with nanobiosensors because they take advantage of the unique properties of nanomaterials. By providing more precise and customized treatment options for hydatid cysts, nanotechnology may improve therapeutic options and strategies for diagnosing the disease. In conclusion, treatment with nanotechnology to treat hydatid cysts is potentially effective but presents many obstacles. Furthermore, nanobiosensors are being integrated into diagnostic techniques, as well as helping to diagnose patients earlier and more accurately.
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Affiliation(s)
- Soheil Sadr
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad 917794897, Iran; (S.S.)
| | - Narges Lotfalizadeh
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad 917794897, Iran; (S.S.)
| | - Amir Mohammad Abbasi
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad 917794897, Iran; (S.S.)
| | - Nooshinmehr Soleymani
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad 917794897, Iran; (S.S.)
| | - Ashkan Hajjafari
- Department of Pathobiology, Faculty of Veterinary Medicine, Islamic Azad University, Science and Research Branch, Tehran 1477893855, Iran
| | | | - Hassan Borji
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad 917794897, Iran; (S.S.)
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15
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Mansour M, Nassar K, Masri M, Kanas M, Aldrea F, Alzaylaa Y, Salloum H, Ahmad Y, Samha R, Kanjawi O. A massive primary hydatid splenic cyst was successfully managed through open total splenectomy: a case report and review article. Ann Med Surg (Lond) 2023; 85:5208-5213. [PMID: 37811073 PMCID: PMC10553008 DOI: 10.1097/ms9.0000000000001217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/12/2023] [Indexed: 10/10/2023] Open
Abstract
Background Cystic echinococcosis (CE) is a parasitic infection that is caused by the tapeworm Echinococcus granulosus. CE is very common, especially in the rural areas of developing countries. The most commonly affected organs by hydatid cysts are the liver and the lungs. However, the primary splenic hydatid cyst (PSHC) is a very rare manifestation of CE with an incidence of 0.5-8%. Case presentation A 17-year-old female patient presented with abdominal pain which gradually increased over months, along with anorexia and vomiting. Computerized tomography showed a massive splenic cystic mass. An open total splenectomy was performed. By follow-up, the platelet count and a postoperative chest X-ray were normal. The patient was prescribed Albendazole and analgesics. The pathological study confirmed the diagnosis of PSHC. Conclusion Despite the occurrence of PSHC being very rare, it is very important to take it into consideration, especially in endemic areas.
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Affiliation(s)
| | | | - Mahmod Masri
- Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Mahmoud Kanas
- Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | | | - Yara Alzaylaa
- Department of Internal Medicine, AlMujtahed Hospital, Damascus
| | | | | | | | - Omar Kanjawi
- Department of General Surgery, Tishreen Hospital, Manbij, Aleppo, Syrian Arab Republic
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16
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Hassan A, Azhar A, Mazhar S, Yadav S, Tahir MB, Basnet R, Bhattarai P. A rare case of recurrent hydatid cyst of the spleen: A case report. Radiol Case Rep 2023; 18:3406-3409. [PMID: 37502480 PMCID: PMC10369391 DOI: 10.1016/j.radcr.2023.06.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/29/2023] Open
Abstract
Cystic echinococcosis (CE), or hydatid disease, is a parasitic infection caused by Echinococcus granulosus endemic to areas with considerable pastoral farming and animal husbandry. Typical presentations include hydatid cyst formation in the liver, lungs, brain, kidneys, or bones. An isolated splenic hydatid cyst is an extremely rare occurrence, accounting for only 0.5%-4% worldwide incidence rates, and recurrent cases are even more infrequent. Globalization, cross-border travel, and altered immigration patterns over time have shifted some of the burden of CE from the developing to the developed world, making the diagnosis challenging for these nonendemic areas. Judicious use of imaging modalities for prompt diagnosis and effective intervention is necessary to treat the initial disease and prevent a recurrence. Herein, we present the case of a 13-year-old male with recurrent isolated splenic hydatid cyst. The patient presented with chronic and nonradiating pain in his left hypochondrium. Physical examination revealed splenomegaly. Ultrasonography showed multiple cysts. Computerized tomography (CT) scan showed cystic lesions in splenic parenchyma with numerous internal enhancing septae. Surgical evacuation was performed for the management of disease.
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Affiliation(s)
- Amna Hassan
- Combined Military Hospital (CMH), Lahore Medical College & Institute of Dentistry, Lahore, Pakistan
| | - Aima Azhar
- Fatima Jinnah Medical University, Lahore, Pakistan
| | - Saad Mazhar
- King Edward Medical University, Lahore, Pakistan
| | | | | | - Rojan Basnet
- Manipal College of Medical Sciences, Pokhara, Nepal
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17
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Sharma A, Yadav GC, Yadav AK, Meena RN. An Unexpected Finding of Isolated Hydatidosis of the Spleen With Concomitant Visceromegaly in an Elderly Female. Cureus 2023; 15:e46346. [PMID: 37920613 PMCID: PMC10618711 DOI: 10.7759/cureus.46346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 11/04/2023] Open
Abstract
Hydatidosis of the spleen is a rare zoonotic clinical entity. The occurrence of isolated splenic hydatid cysts in the absence of these cysts in any other portion of the body is referred to as primary splenic hydatidosis. It is a rare disorder that accounts for only 2% of the burden of hydatid disease worldwide. After the liver and the lungs, the spleen is the organ that is most frequently affected by this condition.
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Affiliation(s)
- Aditya Sharma
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND
| | - Ganesh Chandra Yadav
- Department of General Surgery, Heritage Institute of Medical Sciences, Varanasi, IND
| | - Amit Kumar Yadav
- Department of General Surgery, Maa Vindhyavasini Autonomous State Medical College, Mirzapur, IND
| | - Ram Niwas Meena
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND
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18
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Mohammad S, Joshi KS, Muneeba S, Acharya N, Jajoo SS. Echinococcal Disease of the Fallopian Tube as a Rare Cause of Primary Subfertility. Cureus 2023; 15:e46198. [PMID: 37905297 PMCID: PMC10613431 DOI: 10.7759/cureus.46198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Echinococcosis is a significant zoonotic infection caused by Echinococcus granulosus, which has a worldwide distribution. In India, the annual incidence varies from one to 200 in 100,000 people. The liver and lungs are often affected, making diagnosis difficult when infections occur in uncommon areas. We report a case of a hydatid cyst in the fallopian tube, which presented as subfertility and was confirmed by radiological imaging.
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Affiliation(s)
- Shazia Mohammad
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ketav S Joshi
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shaikh Muneeba
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neema Acharya
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shubhada S Jajoo
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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19
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Lukman K, Sulthana BAAS, Budiman D, Nugraha P. Giant splenic cyst: A case series of rare and challenging cases from the last 22 years. Int J Surg Case Rep 2023; 106:108263. [PMID: 37116278 PMCID: PMC10163636 DOI: 10.1016/j.ijscr.2023.108263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/20/2023] [Accepted: 04/22/2023] [Indexed: 04/30/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Splenic cyst is a rare disease, with reported incidences ranging from 0.07 to 0.3 %. A splenic cyst is typically discovered inadvertently and may not cause any symptoms until it grows to a significant size. In some cases, complications such as acute abdomen may be brought on by an intracystic hemorrhage, rupture, or infection. As a rare disease, diagnosing a splenic cyst is still precarious because only a few cases have been reported. CASE PRESENTATION The first case is a 23-year-old Asian man without a significant history of illness who complains of a left upper quadrant mass that he discovered 10 years prior. Since then, the mass had been gradually growing and had been accompanied by severe pain. Walking made the pain worse; lying down made it lessen. A computed tomography (CT) scan of the abdomen showed a 20.05 × 15.95 × 26.71 cm splenic cyst. Surgery for a peri-cystic splenectomy was done. A primary splenic cyst was identified in the specimen after microscopic and macroscopic examination. After 10 days, the patient was released from the hospital without complications. The second case is that of a 28-year-old Asian man who complained of a mass in their abdomen that was getting bigger in size. Four years prior to the complaint, the patient had fallen while driving a motorcycle, and the left side of his abdomen collided with the sidewalk. In this patient, a splenectomy-the complete removal of all spleen parts-was done. The specimen's macroscopic and microscopic examination revealed a splenic pseudocyst. The patient was discharged after three days without complications. CLINICAL DISCUSSION Splenic cysts are considered rare and challenging to diagnose, as there have been only a limited number of reports. Nevertheless, proper management is still needed, as it carries the risk of rupturing and causing complications such as peritonitis and anaphylactic reactions. Considering the risk of overwhelming post-splenectomy infection (OPSI), conservative treatment can be the gold standard for splenic cysts. However, considering the risk from the size of the cyst, splenectomy or peri-cystic splenectomy is an appropriate surgery option for a splenic cyst. CONCLUSION Splenectomy, or peri-cystic splenectomy, is a surgery option for a splenic cyst with significant size and rupture risk.
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Affiliation(s)
- Kiki Lukman
- Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran / Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
| | - Bambang Am Am Setya Sulthana
- Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran / Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Deny Budiman
- Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran / Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Prapanca Nugraha
- Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran / Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
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20
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Alshoabi SA, Alkalady AH, Almas KM, Magram AO, Algaberi AK, Alareqi AA, Hamid AM, Alhazmi FH, Qurashi AA, Abdulaal OM, Aloufi KM, Alsharif WM, Alsultan KD, Omer AM, Gareeballah A. The Neoplasms Mimicker: A Pictorial Review of Hydatid Disease. Diagnostics (Basel) 2023; 13:diagnostics13061127. [PMID: 36980435 PMCID: PMC10047450 DOI: 10.3390/diagnostics13061127] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Hydatid cyst is a common name for the larval stage of a tapeworm species of the genus Echinococcus granulosus, which is transmitted from animals to humans via the fecal–oral route. Hydatid cysts predominantly affect the liver (75%), followed by the lung (15%), and they can affect many organs in the human body. Medical imaging modalities are the keystone for the diagnosis of hydatid cysts with high sensitivity and specificity. Ultrasound imaging with high resolution is the first choice for diagnosis, differential diagnosis, staging, establishing a role in interventional management, and follow-up, and it can differentiate Type I hydatid cysts from simple liver cysts. Unenhanced computed tomography (CT) is indicated where or when an ultrasound is unsatisfactory, such as with chest or brain hydatid cysts, when detecting calcification, and in obese patients. Magnetic resonance imaging (MRI) is superior for demonstrating cyst wall defects, biliary communication, neural involvement, and differentiating hydatid cysts from simple cysts using diffusion-weighted imaging (DWI) sequences. According to the phase of growth, hydatid cysts occur in different sizes and shapes, which may mimic benign or malignant neoplasms and may create diagnostic challenges in some cases. Hydatid cysts can mimic simple cysts, choledochal cysts, Caroli’s disease, or mesenchymal hamartomas of the liver. They can mimic lung cystic lesions, mycetoma, blood clots, Rasmussen aneurysms, and even lung carcinomas. Differential diagnosis can be difficult for arachnoid cysts, porencephalic cysts, pyogenic abscesses, and even cystic tumors of the brain, and can create diagnostic dilemmas in the musculoskeletal system.
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Affiliation(s)
- Sultan Abdulwadoud Alshoabi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
- Correspondence:
| | | | | | | | | | - Amal A. Alareqi
- Radiology Department, 21 September University of Medical and Applied Science, Sana’a, Yemen
| | | | - Fahad H. Alhazmi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Abdulaziz A. Qurashi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Osamah M. Abdulaal
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Khalid M. Aloufi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Walaa M. Alsharif
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Kamal D. Alsultan
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Awatif M. Omer
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Awadia Gareeballah
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
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21
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Zahoor H, Sari E, Patel J, Guzman N. An Isolated Splenic Hydatid Cyst. Cureus 2023; 15:e36571. [PMID: 37095821 PMCID: PMC10122192 DOI: 10.7759/cureus.36571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 04/26/2023] Open
Abstract
An isolated hydatid cyst of the spleen is a rare presentation of echinococcal diseases, especially in non-endemic areas where it may end up with unnecessary work-up and misdiagnosis. Here, we present the case of a 28-year-old female presenting with generalized abdominal pain, constipation, and early satiety who had a delayed diagnosis of isolated splenic hydatid cyst which was partially treated with albendazole, eventually requiring splenectomy.
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Affiliation(s)
- Hovra Zahoor
- Internal Medicine, HCA Florida Orange Park Hospital, Orange Park, USA
| | - Esra Sari
- Internal Medicine, HCA Florida Orange Park Hospital, Orange Park, USA
| | - Jay Patel
- Internal Medicine, HCA Florida Orange Park Hospital, Orange Park, USA
| | - Nilmarie Guzman
- Internal Medicine, HCA Florida Orange Park Hospital, Orange Park, USA
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22
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Khalili N, Iranpour P, Khalili N, Haseli S. Hydatid Disease: A Pictorial Review of Uncommon Locations. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:118-129. [PMID: 36895460 PMCID: PMC9989246 DOI: 10.30476/ijms.2022.93123.2442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/19/2022] [Accepted: 01/31/2022] [Indexed: 03/11/2023]
Abstract
Hydatid disease is a zoonotic infection caused primarily by the tapeworm parasite, Echinococcus granulosus. It is considered an endemic disease in the Mediterranean region. In about 90% of cases, hydatid cysts are found in the liver and lungs; however, any other organ in the body may be affected, particularly in endemic areas. When encountering cystic lesions in these areas, the physician should always keep hydatid disease as a possible diagnosis in mind. To avoid life-threatening conditions such as anaphylactic shock or pressure effect on vital organs, timely diagnosis, and proper management are critical. When a rare site is involved, hydatid disease should be diagnosed using a combination of serologic assays and imaging modalities such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). These imaging modalities can also be used to determine the extent of the disease and assess possible complications. Here, we present a pictorial review of typical imaging manifestations of hydatid cysts in unusual sites. Being aware of these imaging features will assist physicians in making an accurate, timely diagnosis and subsequently, providing optimal management.
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Affiliation(s)
- Nastaran Khalili
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Pooya Iranpour
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Khalili
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Sara Haseli
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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23
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Atypical presentations of hydatid cyst in children and their management. Indian J Gastroenterol 2022; 41:643-648. [PMID: 36484785 DOI: 10.1007/s12664-022-01283-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/30/2022] [Indexed: 02/03/2023]
Abstract
Hydatid cyst (HC) is uncommon in children and usually involves a single organ, the lung being the most common site followed by the liver. A series of 18 children who presented with HC at different organs of the body managed at our institute over a period of 5 years is presented here. The clinico-radiological evaluation was done in all patients followed by pharmacotherapy/surgery and was followed up for 2 years. Demographic data, organs of involvement, clinical presentations and investigations, response to oral albendazole therapy, surgical procedures, operative findings, perioperative clinical courses, and surgical outcomes were recorded. The mean age of presentation was 7.7 years with a male:female ratio of 11:7. All patients were symptomatic at presentation and four (22.22%) had atypical symptoms (obstructive jaundice, bladder outlet obstruction, and acute abdominal pain). Liver HC was more common than lung HC. Three patients (16.6%) had synchronous involvement of the lung and liver/spleen. All the patients underwent surgical excision of the cyst as none of them responded to preoperative pharmacotherapy. Open surgery was done in 15 patients and laparoscopic excision was carried out in three (16.6%). Two patients had abnormal communications (cysto-biliary/cysto-bronchial), which were managed successfully. Neither any major perioperative morbidity nor mortality was nor any recurrence was seen in a 2-year clinical follow-up, no significant perioperative morbidity or mortality occurred, and no recurrence was noted. In conclusion, single organ HC is more common in children, with more prevalence of hepatic than pulmonary HC. Early surgical excision of the cyst should be considered (preferably laparoscopic whenever possible) instead of pharmacotherapy.
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24
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A giant isolated primary splenic hydatidosis: A case report. Ann Med Surg (Lond) 2022; 84:104863. [PMID: 36582909 PMCID: PMC9793205 DOI: 10.1016/j.amsu.2022.104863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/13/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction and importance: Hydatid cyst disease is caused by Echinococcus tapeworm and is one of the major health problems in endemic regions like Nepal. The cases of splenic hydatidosis are quite rare and giant isolated primary splenic hydatidosis is even rarer. The patients present with vague symptoms or no symptoms at all. Here we report a case of isolated splenic hydatid cyst. So, we should think the differential diagnosis of splenic hydatidosis in any abdominal case of endemic regions. Case presentation A 27-year-old female presented with left-side abdominal pain for the past 7 months without any particular attraction. Abdominal ultrasound showed a well-defined cystic mass on the upper pole with low-level internal floating debris. Contrast Enhanced CT scan showed well defined cystic lesion measuring about 10.8 × 9.6 × 8.5 cm in the upper pole of the spleen with an exophytic component and minimal homogenous wall enhancement. Laparoscopic Splenectomy was done and albendazole for 3 weeks was prescribed after all the patient was completely normal. Clinical discussion In this case, the optimal treatment of giant isolated splenic hydatidosis was splenectomy and prescription of albendazole. Conclusion We believe in any abdominal case of the endemic region, the hydatid cyst of the spleen should be taken as one of the differential diagnoses and should be managed appropriately before the complication arises.
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25
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Singh S, Kisee S, Amatya S, Singh S, Bista S, Shrestha R, Kumar Chhantel Thapa M. A case of giant primary splenic hydatid cyst: Case report. Ann Med Surg (Lond) 2022; 84:104829. [PMID: 36582877 PMCID: PMC9793121 DOI: 10.1016/j.amsu.2022.104829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/29/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction Primary splenic hydatidosis is a rare zoonotic disease, common in grazing regions of the world. Primary splenic hydatid cyst is rare and accounts for <2% of patients. Splenectomy is advocated in case of giant hydatid cyst locating in central and hilum area; however, spleen salvaging operations are done in superficial cyst, cysts localized to one pole of the spleen or cysts that are unresectable due to extensive adhesions and in children. Presentation of case We present a case of 29-year male patient from rural areas presented with the complain of left hypochondriac pain and tenderness along with the history of farming and cattle raising. There was no other significant history. Clinical findings and investigations Physical examination showed mildly distended abdomen, mild tenderness over left hypochondrium. Routine laboratory investigations were sent. Ultrasound and CT scan of the abdomen showed giant splenic cyst measuring approx. 15 × 14 × 11 cm along with daughter cysts. Postoperatively, cyst was sent for histopathological examination. Intervention and outcome Preoperatively, vaccinations against Pneumococcus, Hemophilus influenzae and Meningococcus along with Albendazole (15 mg/kg/day) was given 2 weeks before the planned operation. Total splenectomy was performed and diagnosis was confirmed by histopathological examination. Albendazole was continued for 2 more weeks. Patient remains asymptomatic thereafter and regularly followed up in OPD basis. Relevance and impact Presence of isolated splenic cyst should raise suspicion for primary splenic hydatid cyst in endemic areas. Splenectomy versus spleen salvaging options should be analyzed and performed as per the indications. Splenic hydatid cyst is one of the rare clinical findings and there is very much high chance that it goes undiagnosed during the clinical practice. So, the main motive behind writing this article is to shed knowledge on basic approach to this splenic finding.
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Affiliation(s)
- Sampurna Singh
- Department of Surgery, Kist Medical College, Kathmandu, Nepal
- Corresponding author.
| | - Shreeja Kisee
- Department of Surgery, Kist Medical College, Kathmandu, Nepal
| | - Suprabha Amatya
- Department of Surgery, Kist Medical College, Kathmandu, Nepal
| | - Santosh Singh
- Department of Surgery, Gandaki Medical College, Pokhara , Nepal
| | - Shiwani Bista
- Department of Surgery, Kist Medical College, Kathmandu, Nepal
| | - Rajan Shrestha
- Department of Surgery, Kist Medical College, Kathmandu, Nepal
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26
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Yotsov TI, Dyulgerova S, Draganova D. Laparoscopic splenectomy for solitary splenic hydatid cyst: Case report. J Minim Access Surg 2022; 19:317-319. [PMID: 36124471 DOI: 10.4103/jmas.jmas_113_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hydatid cyst disease is a parasitic disease caused by a type of tapeworm called Echinococcus. It is endemic to cattle-rearing regions of Africa, Asia, South Europe, the Mediterranean, the Middle East and Australia. The most common site of infection is the liver (75%). Involvement of the spleen is rare and occurs in 5% of the cases. Solitary splenic cysts are even rarer (0.5%-4%). We present a case of solitary hydatid cyst of the spleen in a 47-year-old woman. The cyst was asymptomatic and an accidental find on a full-body computed tomography after epileptic seizure and body trauma. The condition was treated successfully with albendazole, but the patient requested the cyst removed. Laparoscopic splenectomy was performed. The specimen was placed in an Endo-Bag and extracted. The patient recuperated well and was discharged on the post-operative day 5. Six months after the procedure, the patient has no complaints.
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Affiliation(s)
- Tsanko Ivelinov Yotsov
- Department of Health Care, University of Ruse 'Angel Kanchev', Ruse; Department of Surgical Nursing Care, Medical University of Pleven, Pleven, Bulgaria
| | - Stela Dyulgerova
- Department of Surgical Nursing Care, Medical University of Pleven, Pleven, Bulgaria
| | - Daniela Draganova
- Department of Health Care, University of Ruse 'Angel Kanchev', Ruse, Bulgaria
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27
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Rosette sign. Abdom Radiol (NY) 2022; 47:2560-2561. [PMID: 35716211 DOI: 10.1007/s00261-022-03564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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28
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Moussas N, Adamidis S, Adamidis N, Stratopoulos C, Gargalianos-Kakolyris P. Isolated Splenic Cystic Echinococcosis and Albendazole hepatotoxicity. IDCases 2022; 28:e01501. [PMID: 35498906 PMCID: PMC9043975 DOI: 10.1016/j.idcr.2022.e01501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022] Open
Abstract
Isolated splenic cystic echinococcosis is a rare condition. In Greece the number of cases has declined substantially in the last 20 years. The spleen is the second most common extrahepatic site of cystic echinococcosis. Albendazole is safe, but mebendazole can be used as a substitute, in case of adverse reaction. Our patient was diagnosed with isolated splenic echinococcal cyst, during the investigation for newly diagnosed type 2 diabetes mellitus. We opted for elective splenectomy, based on a risk assessment due to the patient’s working conditions, and treatment with albendazole represented a safety measure until surgery was possible. The patient developed acute hepatocellular injury to albendazole after eight weeks of treatment. This was confirmed through rechallenge with albendazole after discontinuation of the drug. Postsplenectomy the treatment with mebendazole proved to be safe with no adverse reactions. Even though, albendazole is known to be safe, monitoring of hepatic enzymes and full blood count should be offered. In case of toxicities, mebendazole with or without praziquantel can be used. Toxicity to mebendazole can be similar to albendazole but a trial is worthwhile. In our patient, treatment with mebendazole was uneventful
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Affiliation(s)
- Nikolaos Moussas
- Department of Internal Medicine and Infectious Diseases, Athens Medical Center, Marousi, Greece
- Corresponding author.
| | - Sotirios Adamidis
- 1st Internal Medicine Department, Athens Medical Center, Marousi, Greece
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Sangster GP, Malikayil K, Donato M, Ballard DH. MDCT Findings of Splenic Pathology. Curr Probl Diagn Radiol 2022; 51:262-269. [PMID: 33461801 PMCID: PMC8267054 DOI: 10.1067/j.cpradiol.2020.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/18/2020] [Accepted: 12/31/2020] [Indexed: 01/28/2023]
Abstract
The delineation and characterization of splenic lesions and other abnormalities can be challenging on computed tomography. Many splenic lesions are incidentally found, imaging features tend to overlap, and without the appropriate clinical context, differentials can range from benign to malignant. Radiologists should be familiar with the wide variety of pathologies seen on computed tomography as it is often the first imaging modality a splenic lesion is seen. The purpose of this MDCT-focused review is to understand normal splenic anatomy and its variants, to illustrate and describe typical and atypical imaging patters of inflammatory, infectious, vascular, traumatic, benign, and malignant tumors of the spleen and provide clues in reaching the appropriate differential diagnosis and management.
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Affiliation(s)
- Guillermo P Sangster
- Department of Radiology, Louisiana State University Health Shreveport, Shreveport, LA.
| | - Kiran Malikayil
- Department of Radiology, Louisiana State University Health Shreveport, Shreveport, LA
| | - Maren Donato
- Fundación Medica de Río Negro y Neuquén, Cipolletti, Río Negro, Argentina
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
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30
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Sotirios B, Savas D, Maria-Eleni Z, Stauros V, Sempachedin P. OUP accepted manuscript. J Surg Case Rep 2022; 2022:rjac217. [PMID: 35755015 PMCID: PMC9215355 DOI: 10.1093/jscr/rjac217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/22/2022] [Indexed: 11/14/2022] Open
Abstract
Echinococciasis is a zoonotic infection observed in almost every anatomic location in the body. The liver and lungs are the most frequent sites of infection. However, spleen involvement is rare, and isolated splenic hydatid disease is even less common. Herein, we report a case of isolated splenic hydatid cyst without any tissue involvement that was treated with the classical surgical approach.
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Affiliation(s)
- Botaitis Sotirios
- Correspondence address. Alexandroupolis University Hospital, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece. Tel: +30-2551343224; E-mail:
| | - Deftereos Savas
- Radiology Department, Alexandroupoli University Hospital, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Zachou Maria-Eleni
- Department of Surgery, Alexandroupoli University Hospital, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Vasileiadis Stauros
- Department of Surgery, Alexandroupoli University Hospital, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Perente Sempachedin
- Department of Surgery, Alexandroupoli University Hospital, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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31
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Jarray L, Boughdir M, Maamatou W, Daid A, Ben Abdallah R, Tlili S, Hellal Y, Gharbi Y, Kaabar N. Spleen-sparing excision of giant splenic hydatid cyst. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2021.102088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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32
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Karaosmanoglu AD, Uysal A, Onder O, Hahn PF, Akata D, Ozmen MN, Karcaaltıncaba M. Cross-sectional imaging findings of splenic infections: is differential diagnosis possible? Abdom Radiol (NY) 2021; 46:4828-4852. [PMID: 34047800 PMCID: PMC8160561 DOI: 10.1007/s00261-021-03130-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/12/2021] [Accepted: 05/19/2021] [Indexed: 01/31/2023]
Abstract
The spleen plays an important role in the immunological homeostasis of the body. Several neoplastic and non-neoplastic diseases may affect this organ, and imaging is of fundamental importance for diagnosis. Infectious diseases of the spleen can be encountered in daily radiology practice, and differential diagnosis may sometimes be challenging. Infectious involvement of the spleen can be primary or secondary to a different source outside the spleen. Despite the fact that different infectious diseases may cause similar imaging findings, we believe that differential diagnosis between different causes may also be possible in certain patients with imaging. Early diagnosis may potentially enhance patients’ treatment and outcome. In this review, we aimed to increase imaging specialists’ awareness of splenic infections by describing the multimodality imaging features of common and atypical infections of the spleen with their differential diagnoses.
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Affiliation(s)
| | - Aycan Uysal
- Department of Radiology, Gulhane Training and Research Hospital, Ankara, 06010, Turkey
| | - Omer Onder
- Department of Radiology, Hacettepe University School of Medicine, Ankara, 06100, Turkey
| | - Peter F Hahn
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Deniz Akata
- Department of Radiology, Hacettepe University School of Medicine, Ankara, 06100, Turkey
| | - Mustafa Nasuh Ozmen
- Department of Radiology, Hacettepe University School of Medicine, Ankara, 06100, Turkey
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Trenker C, Görg C, Freeman S, Jenssen C, Dong Y, Caraiani C, Ioanițescu ES, Dietrich CF. WFUMB Position Paper-Incidental Findings, How to Manage: Spleen. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2017-2032. [PMID: 34052061 DOI: 10.1016/j.ultrasmedbio.2021.03.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 06/12/2023]
Abstract
The World Federation for Ultrasound in Medicine and Biology (WFUMB) is addressing the issue of incidental findings (IFs) with a series of publications entitled "Incidental Imaging Findings-The Role of Medical Ultrasound." IFs are less commonly encountered in the spleen than in many other abdominal organs but remain a frequent dilemma in clinical practice. A histological diagnosis is rarely necessary for patient management. Many IFs, such as secondary spleens and splenic cysts, are harmless and do not require any further investigation. The diagnosis of many other focal splenic lesions is, however, often problematic. The following overview is intended to illustrate a variety of incidentally detected spleen pathologies such as size variants, shape variants, secondary spleens, focal splenic lesions and splenic calcifications. It should aid the examiner in establishing the diagnosis. Moreover, it should help the ultrasound practitioner decide which pathologies need no further investigation, those requiring interval imaging and cases in which immediate further diagnostic procedures are required.
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Affiliation(s)
- Corinna Trenker
- Department of Hematology, Oncology and Immunology, University Hospital Giessen and Marburg, Philipps University Marburg, Baldingerstrasse, Marburg, Germany
| | - Christian Görg
- Department of gastroenterology, Interdisciplinary Center of Ultrasound, University Hospital Giessen and Marburg, Philipps University Marburg, Baldingerstrasse Marburg, Germany
| | - Simon Freeman
- University Hospitals Plymouth, Imaging Directorate, Derriford Hospital, Plymouth, United Kingdom
| | - Christian Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland GmbH Strausberg/Wriezen, Akademisches Lehrkrankenhaus Medizinische Hochschule Brandenburg "Theodor Fontane", Germany; Brandenburg Institute for Clinical Ultrasound at Medical University Brandenburg "Theodor Fontane", Neuruppin, Germany
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Cosmin Caraiani
- Department of Medical Imaging, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Elena Simona Ioanițescu
- Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; Center of Internal Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permancence, Bern, Switzerland.
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Chatzifotiou D, Wolf C, Baibakovs A, Werthebach H, Lupascu B, Schnell M. Total Splenectomy for a Giant Isolated Splenic Hydatid Cyst Compressing the Abdominal Viscera: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e931195. [PMID: 34315846 PMCID: PMC8329872 DOI: 10.12659/ajcr.931195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Patient: Female, 49-year-old Final Diagnosis: Echinococcus infection Symptoms: Left upper quadrant abdominal pain Medication:— Clinical Procedure: — Specialty: Surgery
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Affiliation(s)
- Dimitrios Chatzifotiou
- Department of General, Visceral and Thorax Surgery, Hegau Bodensee Clinic, Singen (Hohentwiel), Germany
| | - Christian Wolf
- Department of General, Visceral and Thorax Surgery, Hegau Bodensee Clinic, Singen (Hohentwiel), Germany
| | - Arturs Baibakovs
- Department of General, Visceral and Thorax Surgery, Hegau Bodensee Clinic, Singen (Hohentwiel), Germany
| | - Harald Werthebach
- Department of Diagnostic and Interventional Radiology, Hegau Bodensee Clinic, Singen (Hohentwiel), Germany
| | - Bogdan Lupascu
- Department of General, Visceral and Thorax Surgery, Hegau Bodensee Clinic, Singen (Hohentwiel), Germany
| | - Martin Schnell
- Department of General, Visceral and Thorax Surgery, Hegau Bodensee Clinic, Singen (Hohentwiel), Germany
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35
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Merad Y, Derrar H, Zeggai A, Chadli M, Bemrah N, ElHabachi B. Primary splenic hydatid cyst an unexpected diagnosis: Case report. Ann Med Surg (Lond) 2021; 65:102293. [PMID: 33996047 PMCID: PMC8091878 DOI: 10.1016/j.amsu.2021.102293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 11/02/2022] Open
Abstract
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.
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Affiliation(s)
- Yassine Merad
- Department of Parasitology-Mycology, Central Laboratory, « Hassani Abdelkader » Hospital, University, UDL Faculty of Medicine, Sidi-Bel Abbès, Algeria.,Laboratory of Environmental Information Synthesis, Djillali Liabes University, Sidi-bel-Abbes, Algeria
| | - Hichem Derrar
- Department of Pulmonary Medicine & Lung Diseases, « Hassani Abdelkader » Hospital, University Center, Sidi-Bel Abbès, UDL Faculty of Medicine Sidi-Bel Abbès, Algeria
| | - Ahmed Zeggai
- Department of General Surgery, "Ben Badis" Hospital, Sidi-Bel-Abbès, Algeria
| | - Mohammed Chadli
- Department of Emergency and Surgery, « Hassani Abdelkader » Hospital University Center, UDL Faculty of Medicine, Sidi-Bel-Abbes, Algeria
| | - Nabil Bemrah
- Department of General Surgery, « Hassani Abdelkader » Hospital University Center, UDL Faculty of Medicine, Sidi-Bel-Abbes, Algeria
| | - Boumediene ElHabachi
- Department of General Surgery, « Hassani Abdelkader » Hospital University Center, UDL Faculty of Medicine, Sidi-Bel-Abbes, Algeria
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36
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Ghabisha S, Ahmed F, Al-Wageeh S, Al-Shami E, Al-Naggar K, Chowdhury U, Haider N, Al-Yousofy F. Isolated Giant Primary Splenic Hydatid Cyst in a 10-Year-Old Boy: A Case Report. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2021; 12:55-59. [PMID: 33633478 PMCID: PMC7901557 DOI: 10.2147/phmt.s295280] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/10/2021] [Indexed: 11/23/2022]
Abstract
Hydatid cyst (HD) disease is a parasitic infection produced by cysts containing the larval stage of Echinococcus granulosus. It occurs worldwide, but its prevalence is higher in the rural communities of some developing countries like Yemen, where sheep and cattle raising constitute a crucial component of the agricultural industry. This zoonotic disease spreads due to close contact humans with sheep and dogs. The most involved organs with HC are the liver and lungs. However, other organs may also foster it, such as the spleen, with an incidence rate of between 0.5% and 6%. To the best of our knowledge, primary involvement of the spleen by HC is very rare, and a few cases with isolated spleen HC in children were reported. In this study, a ten-year-old boy with a huge primary splenic HC is reported with chief chief complaint of pain and non-tender bulging in his abdomen’s left upper quadrant. A 20×16×18 cm splenic cystic mass was detected by ultrasonography (US) and confirmed by abdominal computed tomography (CT) scan without macroscopic involvement in other organs. Total splenectomy was carried out for hem. Pathological examinations revealed cystic hydatidosis. We describe this case of an isolated huge spleen HC, which was successfully treated with total splenectomy, focusing on the management and outcome of this disease.
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Affiliation(s)
- Saif Ghabisha
- Department of General Surgery, Ibb University of Medical Science, Ibb, Yemen
| | - Faisal Ahmed
- Urology Research Center, Department of Urology, Al-Thora General Hospital, Ibb University of Medical Science, Ibb, Yemen
| | - Saleh Al-Wageeh
- Department of General Surgery, Ibb University of Medical Science, Ibb, Yemen
| | - Ebrahim Al-Shami
- Urology Research Center, Department of Urology, Al-Thora General Hospital, Ibb University of Medical Science, Ibb, Yemen
| | - Khalil Al-Naggar
- Urology Research Center, Department of Urology, Al-Thora General Hospital, Ibb University of Medical Science, Ibb, Yemen
| | - Umayir Chowdhury
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najm Haider
- Urology Research Center, Department of Urology, Al-Thora General Hospital, Ibb University of Medical Science, Ibb, Yemen
| | - Fayed Al-Yousofy
- Department of Pathology, Faculty of Medicine, Taiz University of Medical Science, Taiz, Yemen
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37
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Mejri A, Arfaoui K, Ayadi MF, Aloui B, Yaakoubi J. Primitive isolated hydatid cyst of the spleen: total splenectomy versus spleen saving surgical modalities. BMC Surg 2021; 21:46. [PMID: 33472623 PMCID: PMC7819254 DOI: 10.1186/s12893-020-01036-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/27/2020] [Indexed: 11/20/2022] Open
Abstract
Background This study aims to describe the clinical features of the isolated primitive splenic hydatid cyst, discuss and compare the different surgical approaches of this uncommon disease. Methods This is a descriptive retrospective study carried out over a period of 7 years extending from January 2013 to December 2019 reporting eight cases of isolated primitive splenic hydatid cysts. Data were collected from the register of the general surgery department of the Jendouba regional hospital. Files concerning another associated hydatid localization were excluded. Four patients underwent total splenectomy and four of them underwent different spleen preserving surgical techniques including resection of the protruding dome, partial splenectomy and pericystectomy. Results The diagnosis was incidentally made in 50% of cases. The main other revealing complaints are pain in the left upper quadrant of abdomen in 25% of cases and a painless renitent mass in the same quadrant in only 12,5%. None of patients who underwent total splenectomy had fever or sings of postoperative sepsis. Compared to those who had total splenectomy, patients who underwent spleen preserving surgery had a longer average hospital stay (9 vs 6,25 days) related to post-operative complications including abscess in the residual cavity after protruding dome resection in one patient and post-operative haemorrhage in one patient. Conclusions The current case series argues in favor of total splenectomy, preferably by laparoscopic route whenever the technical platform allows it, associated with some specific peri-operative therapeutic measures. It seems to be the safest way that helps to avoid post-operative complications of spleen saving surgical modalities. These complications are usually difficult to manage in poor countries with limited technical resources. Total splenectomy guarantees at least a decreased hospital stay, reduced healthcare costs, and the absence of recurrence in highly endemic underdeveloped countries.
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Affiliation(s)
- Atef Mejri
- General Surgery Department, Regional Hospital of Jendouba, Jendouba, Tunisia.
| | - Khaoula Arfaoui
- General Surgery Department, Regional Hospital of Jendouba, Jendouba, Tunisia
| | | | - Badreddine Aloui
- General Surgery Department, Regional Hospital of Jendouba, Jendouba, Tunisia
| | - Jasser Yaakoubi
- General Surgery Department, Regional Hospital of Jendouba, Jendouba, Tunisia
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38
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Mejri A, Arfaoui K, Ayadi MF, Aloui B, Yaakoubi J. Primitive isolated hydatid cyst of the spleen: total splenectomy versus spleen saving surgical modalities. BMC Surg 2021; 21:46. [PMID: 33472623 PMCID: PMC7819254 DOI: 10.1186/s12893-020-01036-8; pmcid: pmc7819254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/27/2020] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND This study aims to describe the clinical features of the isolated primitive splenic hydatid cyst, discuss and compare the different surgical approaches of this uncommon disease. METHODS This is a descriptive retrospective study carried out over a period of 7 years extending from January 2013 to December 2019 reporting eight cases of isolated primitive splenic hydatid cysts. Data were collected from the register of the general surgery department of the Jendouba regional hospital. Files concerning another associated hydatid localization were excluded. Four patients underwent total splenectomy and four of them underwent different spleen preserving surgical techniques including resection of the protruding dome, partial splenectomy and pericystectomy. RESULTS The diagnosis was incidentally made in 50% of cases. The main other revealing complaints are pain in the left upper quadrant of abdomen in 25% of cases and a painless renitent mass in the same quadrant in only 12,5%. None of patients who underwent total splenectomy had fever or sings of postoperative sepsis. Compared to those who had total splenectomy, patients who underwent spleen preserving surgery had a longer average hospital stay (9 vs 6,25 days) related to post-operative complications including abscess in the residual cavity after protruding dome resection in one patient and post-operative haemorrhage in one patient. CONCLUSIONS The current case series argues in favor of total splenectomy, preferably by laparoscopic route whenever the technical platform allows it, associated with some specific peri-operative therapeutic measures. It seems to be the safest way that helps to avoid post-operative complications of spleen saving surgical modalities. These complications are usually difficult to manage in poor countries with limited technical resources. Total splenectomy guarantees at least a decreased hospital stay, reduced healthcare costs, and the absence of recurrence in highly endemic underdeveloped countries.
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Affiliation(s)
- Atef Mejri
- General Surgery Department, Regional Hospital of Jendouba, Jendouba, Tunisia.
| | - Khaoula Arfaoui
- General Surgery Department, Regional Hospital of Jendouba, Jendouba, Tunisia
| | | | - Badreddine Aloui
- General Surgery Department, Regional Hospital of Jendouba, Jendouba, Tunisia
| | - Jasser Yaakoubi
- General Surgery Department, Regional Hospital of Jendouba, Jendouba, Tunisia
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39
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Hashemzadeh S, Rezabakhsh A, Rahbarghazi R, Amini H. A giant splenic hydatid cyst: Why calcified cysts should not be considered as a dead cyst. Clin Case Rep 2021; 9:269-273. [PMID: 33489171 PMCID: PMC7813004 DOI: 10.1002/ccr3.3512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 08/31/2020] [Accepted: 09/24/2020] [Indexed: 12/28/2022] Open
Abstract
Our case report showed that peripheral wall calcification of the hydatid cyst does not mean inactivation of the cyst and calcification of cyst wall may occur in all stages of disease.
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Affiliation(s)
- Shahriar Hashemzadeh
- Tuberculosis and Lung Disease Research CenterTabriz University of Medical SciencesTabrizIran
- Department of General and Thoracic SurgeryTabriz University of Medical SciencesTabrizIran
| | - Aysa Rezabakhsh
- Cardiovascular Research CenterTabriz University of Medical SciencesTabrizIran
| | - Reza Rahbarghazi
- Department of Applied Cell SciencesFaculty of Advanced Medical SciencesTabriz University of Medical SciencesTabrizIran
- Stem Cell Research CenterTabriz University of Medical SciencesTabrizIran
| | - Hassan Amini
- Department of General and Thoracic SurgeryTabriz University of Medical SciencesTabrizIran
- Stem Cell Research CenterTabriz University of Medical SciencesTabrizIran
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40
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Baruah A, Sarma K, Barman B, Phukan P, Nath C, Boruah P, Rajkhowa P, Baruah M, Dutta A, Naku N. Clinical and Laboratory Presentation of Hydatid Disease: A Study From Northeast India. Cureus 2020; 12:e10260. [PMID: 33042698 PMCID: PMC7537570 DOI: 10.7759/cureus.10260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Introduction Hydatid disease is an immense health problem in developing countries. The diagnosis of hydatid cyst is often difficult because of its protean manifestations. Our objective was to evaluate the various clinical and laboratory presentations of hydatid disease and various modalities of treatment from a tertiary care center. Materials and methods We reviewed the clinical and laboratory features of patients presenting with hydatid cyst through retrospective analysis from January 2018 to December 2019 from a tertiary care hospital in northeast India. Results Of the 26 adult patients with hydatid cysts who were part of the study, 14 (53.8%) were males and 12 (46.2%) were females. The mean age was 34.6 years. The most common site of involvement was the liver (69%) followed by lung (19.2%) and brain (7.7%). Palpable mass in the right upper quadrant of the abdomen was the most common symptom (88.3%) for liver hydatid cyst followed by pain abdomen (66.6%). Systemic symptoms like fever and weakness were present in most of the patients. The majority of patients (80%) were from rural areas. Conclusion Hydatid cysts present with varied symptomatology. History of exposure to infected animals may not be present. A high degree of clinical suspicion combined with meticulous history and clinical examination supported by laboratory investigations are required for its diagnosis.
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Affiliation(s)
- Arup Baruah
- Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Kalyan Sarma
- Department of Radiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Bhupen Barman
- Department of Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Pranjal Phukan
- Department of Radiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Chandan Nath
- Department of Biochemistry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Polina Boruah
- Department of Biochemistry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Purnima Rajkhowa
- Department of Microbiology, Silchar Medical College, Silchar, IND
| | - Mriganka Baruah
- Department of Biochemistry, Employees State Insurance Corporation Medical College, Kolkata, IND
| | - Anirban Dutta
- Department of Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
| | - Narang Naku
- Department of General Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND
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41
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Hoteit A, Alimoradi M, Aljoubaei M, Fakhruddin N, Hammoud N. Primary splenic hydatid cyst treated with laparoscopic spleen preserving surgery: A case report. Int J Surg Case Rep 2020; 74:95-98. [PMID: 32829017 PMCID: PMC7452423 DOI: 10.1016/j.ijscr.2020.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 12/01/2022] Open
Abstract
Primary splenic hydatidosis is an uncommon entity. Total splenectomy is considered the standard treatment, but carries multiple risks. Partial splenectomy offers comparable outcomes with reduced morbidity. Partial splenectomy is recommended for simple, single, small, and peripherally located cysts. Laparoscopic cyst unroofing is feasible in treating primary splenic hydatid cysts.
Background Primary splenic hydatidosis is an uncommon etiology. Total splenectomy has been the treatment of choice, however, spleen preserving surgery has been gaining popularity. Case Report We present a case of a 52-year-old man who was evaluated for a splenic cyst, found incidentally on CT scan done at another institution. MRI was repeated in our institution along with an indirect hemagglutination test to confirm the diagnosis. Since our patient had a single non-complicated cyst confined to the spleen’s lower pole, we decided to opt for laparoscopic cyst unroofing and omentoplasty, a spleen preserving technique. Discussion Due to the rarity of splenic hydatidosis, no strict management guidelines are available, and the decision is usually left for the surgeon. Total splenectomy has been considered the standard of care, however, spleen preserving surgical techniques and percutaneous interventions have been suggested as better alternatives. Spleen preserving techniques lead to surgical outcomes comparable to total splenectomy, with the added benefit of preserving the immunological protection provided by the spleen and protecting patients from dramatic complications that might follow total splenectomy, such as overwhelming post-splenectomy infections, which are associated with very high mortality. Conclusion Laparoscopic cyst unroofing and omentoplasty is a feasible surgical technique to treat primary splenic hydatidosis while preserving the spleen’s immunologic function.
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Affiliation(s)
- Ali Hoteit
- Hammoud Hospital University Medical Center, Department of General Surgery, Lebanon.
| | - Mersad Alimoradi
- Lebanese University, Faculty of Medical Sciences, Department of General Surgery, Lebanon.
| | - Malak Aljoubaei
- Hammoud Hospital University Medical Center, Department of Radiology, Lebanon.
| | - Najla Fakhruddin
- Hammoud Hospital University Medical Center, Department of Pathology, Lebanon.
| | - Nasser Hammoud
- Hammoud Hospital University Medical Center, Department of General Surgery, Lebanon.
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Hosseini SV, Al-Qanbar MH, Khazraei H, Khodaei S, Mokhtari M, Iranpour P. Evaluation the Effects of Eucalyptus Essential Oil and Hypertonic Saline as Scolicidal Agents in Induction of Sclerosing Cholangitis in Rabbits. Adv Biomed Res 2020; 9:9. [PMID: 32318359 PMCID: PMC7147516 DOI: 10.4103/abr.abr_210_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 01/01/2020] [Accepted: 01/08/2020] [Indexed: 12/15/2022] Open
Abstract
Background There are several scolicidal agents for inactivation of hydatid cyst protoscolices during surgery, but most of them are associated with adverse side effects such as sclerosing cholangitis (SC) and liver necrosis. The present study aimed to evaluate the adverse effects of Eucalyptus essential oil to induce SC in animal models. Materials and Methods Eighteen rabbits weighting 2000-3500 g were included in three groups for this study. About 0.3 ml of Eucalyptus essential oil (1%), or 5% hypertonic saline, or normal saline was injected for 5 min in the gallbladder. After 4 months, the liver, common bile duct, and duodenum were resected and immediately sent for cholangiography and pathologic studies. Results According to pathological studies, inflammation is more common in Eucalyptus and hypertonic saline groups. Due to cholangiographic studies, stricture was slightly higher in the hypertonic saline group than the Eucalyptus group. Conclusion Thus, 1% Eucalyptus essential oil is at least as safe as 5% hypertonic saline, but for clinical uses, it must be confirmed with further studies.
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Affiliation(s)
| | | | - Hajar Khazraei
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahin Khodaei
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maral Mokhtari
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pooya Iranpour
- Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
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Simultaneous Huge Splenic and Mesenteric Hydatid Cyst. Case Rep Surg 2020; 2020:7050174. [PMID: 32082688 PMCID: PMC7008296 DOI: 10.1155/2020/7050174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/04/2020] [Accepted: 01/20/2020] [Indexed: 12/04/2022] Open
Abstract
Hydatid disease (HD) is caused by Echinococcus granulosus and is endemic in many parts of the world. This parasitic tapeworm can produce cysts in almost every organ of the body, with the liver and lung being the most frequently targeted organs. The spleen and mesentery are unusual locations. We report a case of simultaneous huge splenic and mesenteric hydatid cyst in a 91-year-old male patient. The patient was presented with chronic abdominal pain, increased frequency of defecation, and typical history of animal contact (cattle, sheep, and dogs). After performing imaging studies, he was diagnosed with a simultaneous huge spleen and pelvic mesentery hydatid cyst that was managed surgically by splenectomy, pelvic mesenteric cyst deroofing, and partial cystectomy.
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Milosavljevic V, Veselinovic M, Tadic B, Galun D, Ceranic M, Eric D, Bjelovic M. Laparoscopic Management of Initially Unrecognized Splenic Hydatid Cysts: A Case Report and Review of the Literature. ACTA ACUST UNITED AC 2019; 55:medicina55120771. [PMID: 31817008 PMCID: PMC6956320 DOI: 10.3390/medicina55120771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 11/28/2019] [Accepted: 11/29/2019] [Indexed: 12/03/2022]
Abstract
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.
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Affiliation(s)
| | - Milan Veselinovic
- Clinical Centre of Serbia, Clinic for Digestive Surgery, 11000 Belgrade, Serbia
| | - Boris Tadic
- Clinical Centre of Serbia, Clinic for Digestive Surgery, 11000 Belgrade, Serbia
- Correspondence: ; Tel.: +381-62-388-288
| | - Danijel Galun
- Clinical Centre of Serbia, Clinic for Digestive Surgery, 11000 Belgrade, Serbia
| | - Miljan Ceranic
- Clinical Centre of Serbia, Clinic for Digestive Surgery, 11000 Belgrade, Serbia
| | - Dragan Eric
- Clinical Centre of Serbia, Clinic for Digestive Surgery, 11000 Belgrade, Serbia
| | - Milos Bjelovic
- Clinical Centre of Serbia, Clinic for Digestive Surgery, 11000 Belgrade, Serbia
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Acharya S, Ghimire B, Khanal N. Spontaneous rupture of isolated splenic hydatid cyst without acute abdomen: A case report. Clin Case Rep 2019; 7:2064-2067. [PMID: 31788252 PMCID: PMC6878050 DOI: 10.1002/ccr3.2424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 12/02/2018] [Accepted: 05/15/2019] [Indexed: 12/16/2022] Open
Abstract
Isolated splenic hydatid cyst is a very rare manifestation of hydatid cyst. Rarely, patients present late after the cyst is ruptured. They might not present with usual presentations such as the acute abdomen, anaphylaxis, or urticarial rashes but only with a distended abdomen. Splenectomy is the emergency operative management.
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Affiliation(s)
- Suman Acharya
- Tribhuwan University Teaching HospitalMaharajgunjNepal
| | - Bikal Ghimire
- Tribhuwan University Teaching HospitalMaharajgunjNepal
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Ahmed J, Bin Arif T, Tahir F, Malik F, Parkash O. Hydatid Cyst of Spleen Presenting with Vague Symptoms: A Diagnostic Conundrum. Cureus 2019; 11:e5815. [PMID: 31737457 PMCID: PMC6823059 DOI: 10.7759/cureus.5815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Hydatid cysts are caused by a tapeworm Echinococcus granulosus. They usually occur in the liver. When occurring in spleen they present with vague symptoms which make it difficult for the physicians to diagnose. We present a case of a 10-year-old male who presented with fever, abdominal pain, and burning micturition along with vomiting. Abdominal exam revealed no visceromegaly. Abdominal ultrasound (US) and computed tomography (CT) scan showed multiple hypoechoic and hypo-dense areas, respectively. Splenic abscess, abdominal tuberculosis (TB), pyelonephritis and malignancy were ruled out with appropriate investigations. The patient was not responding to triple therapy of antibiotics (ceftriaxone, metronidazole, and cloxacillin). A final diagnosis of hydatid cyst of spleen was made when serum echinococcus immunoglobulin G (IgG) antibodies were found to be positive. The patient was treated with albendazole and was discharged on improvement. It is vital to be vigilant and consider echinococcal hydatid cyst as a differential in the lesions of spleen, especially if the patient has a rural background.
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Affiliation(s)
- Jawad Ahmed
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Taha Bin Arif
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Faryal Tahir
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Farheen Malik
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Oam Parkash
- Pediatrics, Dow University of Health Sciences, Karachi, PAK
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Manoharan D, Kumar A, Krishna A, Bansal VK. Unusual pseudocyst in a wandering spleen. BMJ Case Rep 2019; 12:12/9/e229948. [PMID: 31492728 DOI: 10.1136/bcr-2019-229948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pseudocysts of the spleen are rare, generally asymptomatic lesions developing secondary to trauma, infection or infarction. When symptomatic, they typically present as non-specific pain in the left hypochondrium, with or without a palpable lump on clinical examination. However, these conventions fail when they occur in a wandering spleen, making imaging critically important. This report describes an unusual case of a 50-year-old who presented with a large cystic mass in a pelvic spleen; imaging facilitated a successful splenectomy and subsequent histopathology revealed a pseudocyst in a wandering spleen.
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Affiliation(s)
- Dinesh Manoharan
- Radiology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Atin Kumar
- Radiology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Asuri Krishna
- General Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Banerjee A, Elangovan E, Mitra KS, Saha A. Labial hydatid cyst - A rare entity. J Oral Maxillofac Pathol 2019; 23:418-421. [PMID: 31942124 PMCID: PMC6948068 DOI: 10.4103/jomfp.jomfp_322_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Hydatid cyst is a parasitic infestation by tapeworm Echinococcus. This endemic disease is prevalent in the Middle East and Southeast Asian populations. This zoonotic disease is mainly transmitted by cattle and dogs. Few studies have been reported in the head-and-neck region. There are very few isolated cases have been reported within the oral cavity region. No case until now has been isolated from the labial mucosa. We now present one such case here.
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Affiliation(s)
- Abhishek Banerjee
- Department of Oral and Maxillofacial Pathology, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India
| | - Elampavai Elangovan
- Department of Oral and Maxillofacial Pathology, NSVK Dental College, Bengaluru, Karnataka, India
| | | | - Alangkar Saha
- Department of Oral and Maxillofacial Surgery, Bardhaman Dental College and Hospital, Bardhaman, West Bengal, India
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Manciu S, Tudor S, Vasilescu C. Splenic Cysts: A Strong Indication for a Minimally Invasive Partial Splenectomy. Could the Splenic Hilar Vasculature Type Hold a Defining Role? World J Surg 2018; 42:3543-3550. [PMID: 29717347 DOI: 10.1007/s00268-018-4650-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The aim of the study is to assess the impact of the splenic hilar vasculature configuration on the amount of remnant splenic parenchyma volume after partial splenectomy for splenic cysts. METHODS The data of all patients receiving a splenectomy for a splenic cyst from 2002 to 2016 at the Center of General Surgery and Liver Transplantation of Fundeni Clinical Institute were retrospectively reviewed. The size and location in the splenic parenchyma of the cyst and the splenic hilar vasculature type were assessed for each patient with a splenectomy. RESULTS Thirty-one patients with non-parasitic and 32 patients with hydatid cysts were recorded. In cases of centrally located cysts, a total splenectomy was performed for the majority of cases, while in peripheral cysts a spleen-preserving surgery was feasible for most of the patients (p = 0.001). The size of the cyst was significantly higher in the group of patients with a total splenectomy, compared with the group with a partial splenectomy (p = 0.003). In the subgroup with a distributed arterial pattern, preservation of more than 50% of the initial parenchyma was achieved in a significantly higher proportion of patients, compared with the subgroup of patients with a magistral pattern (p = 0.012). CONCLUSION Besides cyst size or peripheral location in the splenic parenchyma, the vascular pattern is also considered another decisive factor that associates with successful conservative or minimally invasive approach.
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Affiliation(s)
- Simona Manciu
- Department of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 258 Fundeni Street, Bucharest, Romania
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Stefan Tudor
- Department of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 258 Fundeni Street, Bucharest, Romania
| | - Catalin Vasilescu
- Department of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 258 Fundeni Street, Bucharest, Romania.
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
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Devi MA, Venumadhav T, Sukanya B, Manmada RT, Gopal P, Rammurti S. Role of Imaging in Diagnosis, Predicting Biological Activity and in Treatment Plan of Hydatid Disease. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojim.2018.83018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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