Splenic hydatid infection is a rare form of Hydatid disease, and isolated splenic involvement is even less common.
Splenic hydatid disease has been reported to constitute up to 4% of cases of abdominal hydatid disease 4.
Splenic hydatid cysts are usually solitary. As the hydatic cyst increases in size it may lead to compression of the hilar vessels of the spleen, resulting in pericystic splenic atrophy. Eventually the cyst may completely replace the splenic parenchyma. Chronic pericystic inflammation may cause adhesion with adjacent organs or even fistulization between the cyst and nearby organs such as the stomach, pancreas, left colon, left kidney or bronchus 2.
Source of infection
- systemic dissemination
- intraperitoneal spread from a ruptured hepatic hydatid cyst 1
- retrograde spread from the liver to the spleen via the hepatic portal and splenic veins in portal hypertension 2
Splenic hydatid cysts are generally asymptomatic. When the cyst reaches an advanced size, the patient presents with a painful mass in the left hypochondrium 4.
Symptoms are nonspecific and include:
- abdominal pain
- enlarged spleen
Imaging findings are similar to those of hepatic hydatid disease and range from purely cystic lesions to a completely solid appearance 1.
Ultrasonography and CTare the most valuable imaging techniques for the diagnosis and evaluation of focal splenic diseases 3.
The differential diagnosis for splenic hydatid cysts includes other splenic cystic lesions:
- splenic epidermoid cysts
- splenic pseudocysts
- splenic abscesses
- splenic haematomas
- cystic neoplasms of the spleen 4
Treatment and prognosis
Management options include surgery but owing to the risk of spontaneous or traumatic rupture, splenic hydatid cysts are usually treated surgically with a total or partial splenectomy. Albendazole therapy is the mainstay of treatment in the postoperative follow-up period 4.
- secondary infection is rare and usually occurs by haematogenous spread 2
- cyst rupture
- anaphylactic shock 3
- normal appearance of the spleen
- pseudolesion of the spleen: inhomogeneous splenic enhancement
splenic lesions and anomalies
- congenital anomalies
- mass lesions
- infiltrative processes
- incidental splenic lesion (approach)
- 1. Xu Y, Ding J, Wu LY et-al. iSNO-PseAAC: Predict Cysteine S-Nitrosylation Sites in Proteins by Incorporating Position Specific Amino Acid Propensity into Pseudo Amino Acid Composition. PLoS ONE. 7;8 (2): e55844. doi:10.1371/journal.pone.0055844 - Pubmed citation
- 2. Rahmani Sh, Mohammadi Tofigh A. Spleen-Preserving Surgery Versus Splenectomy for Splenic Hydatid Cyst: Ten Years Experience. Shiraz E-Medical Journal Vol. 9, No.2, April 2008.
- 3. Franquet T, Montes M, Lecumberri FJ et-al. Hydatid disease of the spleen: imaging findings in nine patients. AJR Am J Roentgenol. 1990;154 (3): 525-8. AJR Am J Roentgenol (abstract) - Pubmed citation
- 4. Karabicak I, Yurtseven I, Yuruker SS et-al. Splenic hydatid cyst. Can J Surg. 2009;52 (5): E209-10. Free text at pubmed - Pubmed citation