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Jallali M, Chaouch MA, Zenati H, Hassine HB, Saad J, Noomen F. Primary isolated hydatid cyst of the spleen: A case report. Int J Surg Case Rep 2024; 117:109552. [PMID: 38513415 PMCID: PMC10966143 DOI: 10.1016/j.ijscr.2024.109552] [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: 01/30/2024] [Revised: 03/11/2024] [Accepted: 03/15/2024] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Primary (isolated) splenic hydatid cyst is rare and accounts for less than 2 % of hydatid patients, even in endemic regions. Diagnosis of splenic hydatid cyst can be challenging due to the rarity of the condition and its nonspecific symptoms. Surgery is the mainstay of treatment. This case report discusses management options for such a rare condition. CASE PRESENTATION We present a 33-year-old female patient with abdominal pain for six months and splenomegaly. Ultrasonography and CT scan showed a giant splenic cyst with clear walls and multi-vesicular contents suggestive of a hydatid cyst. There was no involvement of the liver or other organs. Indirect hemagglutination was positive for Echinococcus. Through a left subcostal incision total splenectomy was performed. The patient was discharged from hospital on the sixth postoperative day. No local recurrence was detected during postoperative follow up. CASE DISCUSSION Primary splenic hydatid disease is rare. It may be detected incidentally or present with nonspecific complaints. If untreated, a splenic hydatid cyst can lead to various potentially severe complications, including cyst rupture and secondary infection. Standard treatment is open total or partial splenectomy: preservation surgery should always be considered, to avoid post splenectomy infection, especially in young patients. CONCLUSION Primary splenic hydatid cyst is rare even in endemic areas. Symptoms may be non-specific. Standard treatment is open total or partial splenectomy.
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Affiliation(s)
- Maissa Jallali
- Department of Visceral and Digestive Surgery, Monastir University Hospital, Monastir, Tunisia
| | - Mohamed Ali Chaouch
- Department of Visceral and Digestive Surgery, Monastir University Hospital, Monastir, Tunisia.
| | - Hanen Zenati
- Department of Visceral and Digestive Surgery, Monastir University Hospital, Monastir, Tunisia
| | - Hiba Ben Hassine
- Department of Visceral and Digestive Surgery, Monastir University Hospital, Monastir, Tunisia
| | - Jamel Saad
- Department of radiology, Monastir University Hospital, Monastir, Tunisia
| | - Faouzi Noomen
- Department of Visceral and Digestive Surgery, Monastir University Hospital, Monastir, Tunisia
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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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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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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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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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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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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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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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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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