Surgical treatment of splenic hydatidosis: Report of a case

Hydatid disease is a zoonitic infection caused by Echinococcus granulosus and rarely by multilocularis, that affects predominantly liver, to a lesser extent lung and occasionally other organs. This paper discusses a case study conducted at our Institute to evaluate the surgical management of splenic hydatidosis, and to illustrate the utility of a range of new techniques. Splenic involvement alone is a rare event, even in endemic countries; many patients have no symptoms and its diagnosis can be either made fortuitously during diagnostic procedures such as chest or abdomen X-ray, or based on the appearance of those local symptoms caused by the pressure of growing cyst. The treatment of hydatidosis traditionally consists of surgery, either conservative or radical, along with a perioperative course of antielmintic medications. A number of therapeutic options for splenic localization exist, including conservative treatments such as Percutaneous Aspiration, Injection and Reaspiration (PAIR), cyst enucleation and partial splenectomy; and radical interventions such as total splenectomy. The splenectomy remains today, as it was in the past, the treatment of choice for the radical treatment of the disease under consideration because of its associated rates of low mortality, low relapse and low hemorrhagic complications. The laparoscopic approach has to be reserved for well-selected cases: small cysts without adhesion to others organs.