Primer dalak hidatik kist hastalığı: Olgu serisi

Year 2017, Volume: 2 Issue: 2, 31 - 34, 19.04.2017

Ayetullah Temiz , Yavuz Albayrak , Sadettin Er Ayşe Albayrak Onur Bora Aslan

https://doi.org/10.25000/acem.302081

Cited By: 3

Abstract

Amaç: Dalağın izole hidatik kist hastalığı endemik bölgelerde nadiren görülür. Biz bu çalışmada yetişkinlerde primer splenik hidatik kist hastalığı ile ilgili deneyimimizi sunuyoruz.

Yöntemler:  Kliniğimize müracaat eden ve ameliyat edilen on bir izole dalak hidatik kist hastasını retrospektif inceledik. 

Bulgular: Primer splenik hidatik kist  ameliyatı yapılan 11 hastanın altısı (% 54.5) erkek, 5'i (% 45.5) kadın idi. Ortalama dalak büyüklüğü 14.2 cm (10-22 cm) uzunluğunda idi.. Ortalama kist çapı 10.1 cm (5-20 cm) idi. Dokuz hastaya (% 81) cerrahi girişim olarak splenektomi yapıldı ve iki hastaya (% 18) dalak koruyucu cerrahi olarak kistotomi, parsiyel kistektomi ve tüp drenaj işlemleri yapıldı. Splenektomi yapılmayan iki hastanın birinde kist dalak alt polde , diğerinde ise  santral yerleşimli idi.

Sonuç: Dalağın  izole hidatik kist hastalığı  nadir görülebilen bir durumdur. Abdominal tomografi hastalığı saptamada en etkin yöntemdir. Dalağın hidatik kist hastalığın tedavisi cerrahidir. Cerrahi yöntem için sağlanmış  optimal konsensus bulunmamaktadır.

Keywords

Splenik kist hidatik hastalığı, splenektomi, splenomegali

Primary splenic hydatidosis: Case series

Abstract

Aim: Primer hydatid cysts of the spleen are very rarely seen in endemic regions. We report here our experience with primary splenic hydatid cysts in adults.

Methods: We retrospectively analyzed eleven isolated spleen hydatid cyst cases who applied to our clinic and underwent surgery.

Results: Among the 11 patients who underwent operations for primer splenic hydatid cyst disease , six patients (54.5%) were male and five patients (45.5%) were female. The average spleen size was 14.2 cm (10–22 cm) in length. The average cyst diameter was 10.1 cm (5–20 cm). Nine (81%) patients underwent splenectomy as the surgical procedure and two (18%) patients underwent cystotomy, partial cystectomy, and tube drainage processes as spleen protective surgery. Two patients could not undergo splenectomy because the cyst was localized in the spleen lower pole in one patient and was centrally localized in the other patient.

Conclusion: Primer splenic hydatid cyst is a rare condition. Abdominal  tomography is the best method for diagnosing splenic hydatid cyst. The treatment of splenic hydatid cysts is surgically. No exact consensus has been reached regarding the selection of an optimal surgical procedure. 

Keywords

Splenic Hydatidosis, splenectomy, Splenomegaly

References

• 1. McManus DP, Zhang W, Li J, Bartley PB. Echinococcosis. Lancet 2003;362: 1295–1304.
• 2. Eckert J, Deplazes P. Biological, epidemiological, and clinical aspects of echinococcosis, a zoonosis of increasing concern. Clin. Microbiol Rev 2004; 1: 107-35.
• 3. Örmeci N, Soykan I, Palabiyikoğlu M, Idilman R, Erdem H, et al. A new therapeutic approach for treatment of hydatid cysts of the spleen. Dig Dis Sci 2002; 47: 2037–44.
• 4. Durgun V, Kapan S, Kapan M, Karabiçak I, Aydogan F. Primary splenic hydatidosis. Dig Surg 2003; 20: 38–41.
• 5. Manouras AJ, Nikolaou CC, Katergiannakis VA, Apotolidis NS, Golematis BC. Spleen-sparing surgical treatment for echinococcosis of the spleen. Br J Surg 1997; 84: 1162–74.
• 6. Safioleas M, Misiakos E, Manti C. Surgical treatment for splenic hydatidosis World J Surg 1997; 21: 374-78.
• 7. Kapmaz A. Hidatik kist: Epidemiyoloji, Bulaşma yolları ve Korunma yolları. İ.Ü. Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri Sempozyum dizisi no:28. Ocak 2002: 285-89.
• 8. Rasheed K, Zargar SA, Telwani AA. Hydatid cyst of spleen: a diagnostic challenge. N Am J Med Sci 2013; 5: 10–20.
• 9. Ameur HB, Affes N, Abdelhedi C, Kchaou A, Boujelbene S, Beyrouti MI. Hydatid cyst of the spleen: Tunusian series of 21 cases. Indian J Surg 2015; 77 (suppl 2): 515-9.
• 10. Ammann RW, Eckert J. Cestodes. Echinococcus. Gastroenterol Clin North Am 1996; 25: 655–89.
• 11. Kireşi DA, Karabacakoğlu A, Odev K, Karaköse S. Uncommon locations of hydatid cysts. Acta Radiol 2003; 44: 622–36.
• 12. Ibrarullah M, Sreenivasa D, Sriram P, Haragopal M. Hydatid cyst of spleen. Trop Gastroenterol 1999; 20: 55–6.
• 13. Hunter GW, Strickland GT. Hunter’s Tropical medicine and emerging infectious diseases. 8th ed. Philadelphia: Saunders; 2000. pp. 866–76.
• 14. Garcia LS, Bruckner DA. Tissue cestodes: larval forms. In: Garcia LS, editor. Diagnostic medical parasitology. 4th ed. Washington, D.C. ASM Press; 2001. pp. 387–403.
• 15. Von-Sinner WN, Stridebeck H. Hydatid disease of the spleen. Ultrasonography, CT and MR imaging. Acta Radiol 1992; 33: 459–61.
• 16. Ozdogan M, Baykal A, Keskek M, Yorganci K, Hamaloglu E, Sayek I. Hydatid cyst of the spleen: treatment options. Int Surg 2001; 86: 122-6.
• 17. Gharbi HA, Hassine W, Brauner MW, Dupuch K. Ultrasound examination of the hydatic liver. Radiology 1981; 139: 459-63.
• 18. Dahniya MH, Hanna RM, Ashebu S, Muhtaseb SA, el-Beltagi A, et al. The imaging appearances of hydatid disease at some unusual sites. Br J Radiol 2001; 74: 283-9.
• 19. Hansen MB, Moller AC. Splenic cysts. Surg Laparosc Endosc Percutan Tech 2004; 14: 316-22.
• 20. Balik AA, Celebi F, Basoglu M, Oren D, Yildirgan I, Atamanalp SS. Intra-abdominal extrahepatic echinococcosis. Surg Today 2001; 31: 881–4.
• 21. Vasilescu C, Tudor S, Popa M, Tiron A, Lupescu I. Robotic partial splenectomy for hydatid cyst of the spleen. Langenbecks Arch Surg 2010; 395: 1169–74.
• 22. Rodríguez-Leal GA, Morán-Villota S, Milke-García Mdel P. Splenic hydatidosis: A rare differential diagnosis in a cystic lesion of the spleen. Rev Gastroenterol Mex 2007; 72: 122–5.
• 23. Culafić DM, Kerkez MD, Mijac DD, Lekić NS, Ranković VI, et al. Spleen cystic echinococcosis: clinical manifestations and treatment. Scand J Gastroenterol 2010; 45: 186–90.
• 24. Atmatzidis K, Papaziogas B, Mirelis C, Pavlidis T, Papaziogas T. Splenectomy versus spleen-preserving surgery for splenic echinococcosis. Dig Surg 2003; 20: 527–31.
• 25. Fernández-Ruiz M, Guerra-Vales JM, Enguita-Valls AB, Vila- Santos J, García-Borda FJ, Morales-Gutiérrez C. Splenic hydatid cyst, a rare location of extrahepatic echinococcosis: Report of six cases. Eur J Intern Med 2008; 19: 51–3.
• 26. Gharaibeh KIA. Laparoscopic excision of splenic hydatid cyst. Postgrad Med J 2001; 77: 195–6.
• 27. Khoury G, Abiad F, Geagea T, Nabout G, Jabbour A. Laparoscopic treatment of hydatid cysts of the liver and spleen. Surg Endosc 2000; 14: 243–5.
• 28. Ballaux KEW, Himpens JM, Leman G. Hand-assisted laparoscopic splenectomy for hydatid cyst. Surg Endosc 1997; 11: 942–943.
• 29. Mooraki A, Rahbar MH, Bastani B. Spontaneous systemic anaphylaxis as an unusual presentation of hydatid cyst: report of two cases. Am J Trop Med Hyg 1996; 55: 302–3.