Page 54 - World Journal of Laparoscopic Surgery

CASE REPORT
Laparoscopic Management of Hydatid Cyst of Spleen: A Rare

Case Report

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Nalinikanta Ghosh , Ashok Kumar , Nishant Malviya 3
AbstrAct
Aim: Aim of reporting this case is to show the feasibility and outcomes of laparoscopic splenectomy in hydatid disease of spleen.
Background: Hydatid cyst is a zoonotic disease and it can affect humans. It can involve any organ; liver is the most common organ to involve, and
in rare cases spleen could also be involved. Isolated splenic involvement is even rarer. Management is splenectomy. Laparoscopic splenectomy
is feasible if uncontrolled spill is avoidable. Here we are presenting a case of laparoscopic splenectomy in an isolated splenic hydatid cyst.
Case description: A 41 years old lady presented with left upper abdominal Pain for six months. There was no chest or other abdominal
complaints. Examination revealed a palpable spleen. Ultrasonography abdomen, contrast-enhanced computed tomography, and hydatid
serology help to diagnose splenic hydatid, cystic echinococcosis type. Vaccination and perioperative albendazole were administered. She
underwent laparoscopic splenectomy. Standard steps were followed to prevent spillage. The specimen was delivered through Pfannenstiel
incision. Cut-section demonstrated hydatid membranes.
Conclusion: Isolated splenic hydatid is rare and rarely managed laparoscopically. It should be practiced when expertise available.
Clinical significance: Rare entity of isolated splenic hydatid cyst could be treated by laparoscopic method without causing any perioperative
spill or complications and preserve all benefits of laparoscopic surgery in presence of expertise.
Keywords: Laparoscopic splenectomy, Splenic hydatid cyst.
World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1437

bAckground 1–3 Department of Surgical Gastroenterology, Sanjay Gandhi
Hydatid cyst is a zoonotic disease. Humans are accidental hosts Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh,
and known as dead end in the chain of transmission. The liver is India
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the most common site of infection followed by the lungs. It can be Corresponding Author: Ashok Kumar, Department of Surgical
disseminated to any part of the body. Spleen is rarely affected and Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical
isolated affection is even rarer. There are only a few cases reports Sciences, Lucknow, Uttar Pradesh, India, Phone: +91 522 2495537,
in the literature. Surgery is the preferred treatment modality with e-mail: drashok97@gmail.com
perioperative albendazole. Open surgery is usually preferred to How to cite this article: Ghosh N, Kumar A, Malviya N. Laparoscopic
prevent spillage but a laparoscopic approach is feasible. We are Management of Hydatid Cyst of Spleen: A Rare Case Report. World J
presenting a case of symptomatic isolated splenic hydatid that was Lap Surg 2021;14(1):55–57.

managed with laparoscopic splenectomy. Source of support: Nil
Conflict of interest: None
cAse description
A 41 years old lady presented with complaints of mild, dull aching spleen with a well-defined cystic lesion with a thin enhancing wall
pain in the left upper abdomen for 6 months. There was no pet seen in the lower pole, measuring 11.5 × 10.5 × 9 cm. No septa
breeding at home or in neighbor. She had no fever, jaundice, or or calcification or mural nodule demonstrated, and there was
loss of appetite or weight. She had no altered bowel habits. She no other lesion in the abdomen. With these findings, she was
did not complain of recurrent infections or easy bruising. She was diagnosed with asymptomatic splenic hydatid cyst probably cystic
averagely built and nourished. There was no cervical, axillary, echinococcosis type (Fig. 1). She was planned for splenectomy
or inguinal lymphadenopathy. Chest examination was normal. along with the removal of cyst. With available expertise in
The spleen was palpable 4 cm below the left costal margin. No advanced laparoscopy, she was planned for laparoscopic
hepatomegaly or free fluid in the abdomen. With this, she was splenectomy. She was vaccinated against all three capsulated
diagnosed with splenomegaly with no symptoms suggestive of organisms. Two 10 mm and two 5 mm ports were placed as
hypersplenism. Her hemogram, renal and liver function tests, and per convenience (Fig. 2). Standard steps were followed for
coagulation profile were normal. Chest X-ray was normal. She was splenectomy, and the spleen was removed through Pfannenstiel
evaluated with abdominal ultrasonography (USG), which revealed incision. There was no spillage of contents. Surgical specimen
an 11.3 × 11.2 × 10 cm cystic lesion in the inferior pole of the spleen and its cut-section were shown in Figure 3. Histopathological
with dependent hyperechoic contents. Echinococcal IgG (ELISA) examination demonstrated hydatid membranes. Postoperative
was positive. Contrast-enhanced CT (CECT) revealed an enlarged course was uneventful and she was advised three weeks of

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