Surgical decision-making in splenic hydatid cyst management via successful total splenectomy: a case report
Abstract
Background: Echinococcosis classifies as a helminthic zoonosis affecting more than 3 million people. The outcome depends on the affected organ and implicated structures, with a lack of treatment in the long-term resulting in up to 90% of patients dying; even after treatment, the overall lifespan is reduced by 1-2 years. Postoperative death can reach as high as 2.2% if E. granulosum cysts are involved with organs other than the liver and lungs, which are considered very rare. This case aims to document this unique and personalized surgical approach for this rare presentation of splenic hydatid cysts.
Case presentation: We present the case of a 43-year-old white female patient of Central European (Swiss) ethnic background who presented with an Echinococcus infection of the spleen. Following a biking accident, a chest x-ray incidentally revealed a solitary hydatid cyst in the spleen, characterized by extensive plate-like wall calcifications and measuring over 8-cm in length. The unilocular characteristics with a thick wall presence in combination with a high degree of calcification, absence of daughter cysts, positive serum markers are characteristic of a type V hydatid cyst (Gharbi classification)/CE5m (World Health Organization-Informal Working Group on Echinococcosis classification). With guidelines lacking a diagnostic and preoperative investigation pathway for splenic involvement, we conducted a full series with three dimensional reconstruction in computed tomography and…
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