Case Report: Laparoscopic Excision of a Primary Giant Splenic Hydatid Cyst: Literature Review

Am J Trop Med Hyg. 2019 Oct;101(4):821-827. doi: 10.4269/ajtmh.19-0400.

Abstract

Cystic echinococcosis (CE), also known as hydatid cyst, is a zoonosis caused by the tapeworm Echinococcus granulosus. It is a common health problem in many countries. This condition predominantly affects the liver and the lungs, and the spleen to a less extent (splenic hydatid cyst, SHD). Indeed, it is estimated that SHD occurs in less than 2% of abdominal CE and 0.5-8% of CE cases. Here, we present a case of a 44-year-old Chinese woman with primary giant SHD who experienced pain in the left hypochondrium for 10 days. A combination of abdominal ultrasonography and computed tomography (CT) were used for preoperative diagnosis. Laparoscopic splenectomy was performed without any complications, and albendazole (400 mg per day) was administered postoperatively for 3 months. At 3-, 6-, 12-, and 24-month follow-up, the patient remained symptoms free, and abdominal CT found no signs of recurrence. In addition to this case, we review the previous literature on SHD treated by laparoscopy and reveal that laparoscopic approach is safe and effective for SHD. Particularly, we show that laparoscopic splenectomy is feasible for giant cysts (> 10 cm) at high risk of rupture or compressing other vital structures.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdomen / diagnostic imaging
  • Abdomen / pathology
  • Adult
  • Animals
  • Echinococcosis / diagnostic imaging*
  • Echinococcosis / parasitology
  • Echinococcosis / pathology
  • Echinococcus granulosus / isolation & purification*
  • Female
  • Humans
  • Laparoscopy*
  • Spleen / diagnostic imaging
  • Spleen / parasitology
  • Spleen / pathology
  • Splenic Diseases / diagnostic imaging*
  • Splenic Diseases / parasitology
  • Splenic Diseases / pathology
  • Tomography, X-Ray Computed
  • Ultrasonography