The Effect of Hepatic Hydatid Cysts on the Size of Spleen

Year 2011, Volume: 28 Issue: 1, 8 - 11, 15.02.2012

Kadir Dicle Cafer Polat Bünyamin Şahin Bülent Güngör Ayfer Kamalı Polat Kenan Erzurumlu

Abstract

No previous study has yet reported the effects of surgical treatment of hydatid cysts on spleen volume. Our aim was to use computed tomography images to evaluate the volume differences in the spleen in postoperative periods in patients who had undergone operations for hydatid cysts. The abdominal computed tomography scans of 20 patients who had undergone drainage of a hydatid cyst and omentopexy operation were examined retrospectively. The volume of the liver, the cyst, and the spleen were estimated using the Cavalieri principle of stereological methods. The volume fraction of the hydatid cyst to the liver was also estimated using the obtained volume data. The volumes of the spleen (± SD) were 302.0 ± 115.1 cm3 and 259.5±82.4 cm3 in the postoperative 1st week and 6 months, respectively (p<0.05). The volumes of the liver (± SD) were 2264.0 ± 719.2 cm3 and 1651.0 ± 265.6 cm3 in the postoperative 1st week and 6 months, respectively (p<0.05). The liver volume decreased significantly during the healing process (p<0.05). The mean cyst volume was 417.4 ± 649.9 cm3. The volume fraction of the cyst within the liver was 15.2±21.0%. There were no correlations among liver, spleen, and cyst size of the patients (p>0.05). The volume of spleen decreased after hydatid cyst surgery. This may be due to the decreased portal venous pressure of the liver. Additionally, the loss of immune stimulation may have resulted in reduction in splenic volume. Our results also indicated that stereological methods can be used to monitor volume changes of the liver and spleen.

Keywords

Hepatic hydatid cyst, Splenomegaly, Cavalieri principle, Stereology, Computed tomography

References

• Ammann, R.W., Eckert, J. 1996. Cestodes: Echinococcus. Gastro. Clin. North America. 25, 655-689.
• Başoğlu, A., Büyükkarabacak, Y., Sahin, B., Kaplan, S. 2007. Volumetric evaluation of the lung expansion following resection: a stereological study. Eur. J. Cardiothorac. Surg. 31, 512-517.
• Bentley, M.D., Karwoski, R.A. 1988. Estimation of tissue volume from serial tomographic sections. A statistical random marking method. Invest Radiol. 23, 742-747.
• Cruz-Orive, L.M. 1997. Stereology of single objects. J. Microsc. 186, 93-107.
• Dachman, A.H., MacEneaney, P.M., Adedipe, A., Carlin, M., Schumm, L.P. 2001. Tumor size on computed tomography scans: is one measure ment enough? Cancer. 91, 555-560.
• De Odorico, I., Spaulding, K.A., Pretorius, D.H., Lev-Toaff, A.S., Bailey, T.B., Nelson, T.R. 1999. Normal splenic volumes estimated using three-dimensional ultrasonography. J. Ultrasound. Med. 18,231-236.
• Dziri, C. 2001. Hydatid Disease: Continuous serious public health problem. World J. Surg. 25,1-3.
• Dziri, C., Haouet, K., Fingerhut, A. 2004. Treatment of hydatid cyst of the liver: Where is the evidence? World J. Surg. 28,731-736.
• Eckert, J., Deplazes, P. 2004. Biological, epidemiological, and clinical aspects of echinococcosis, a zoonosis of increasing concern. Clin. Micro- biol. Rev. 17, 107-135.
• Hokelek, M., Deger, B.A., Deger, E., Tutar, E., Sunbul, M. 2002. Ivermectin used in percutaneous drug injection method for the treatment of liver hydatid disease in sheep. Gastroenterology. 122, 957-962.
• Junghanss, T., da Silva, A.M., Horton, J., Chiodini, P.L., Brunetti, E. 2008. Clinical management of cystic echinococcosis: state of the art, prob lems, and perspectives. Am. J. Trop Med. Hyg. 79, 301-311.
• Kern, P. 2003. Echinococcus granulosus infection: clinical presentation, medical treatment and outcome. Langenbecks Arch. Surg. 388,413– 420.
• Mazonakis, M., Damilakis, J., Maris, T., Prassopoulos, P., Gourtsoyiannis, N. 2000. Estimation of spleen volume using MR imaging and a ran dom marking technique. Eur. Radiol. 10,1899-1903.
• Mazonakis, M., Damilakis, J., Mantatzis, M., Prassopoulos, P., Maris, T., Varveris, H., Gourtsoyiannis, N. 2004. Stereology versus planimetry toestimate the volume of malignant liver lesions on MR imaging. Magn. Reson. Imaging. 22,1011-1016.
• Mc Manus, D.P., Zhang, W., Li, J., Bartley, P.B. 2003. Echinococcus. Lancet. 362, 1295-1304.
• Moro, P.L., Schantz, P.M. 2006. Echinococcosis: historical landmarks and progress in research and control. Ann Trop. Med. Parasitol. 100,703- 714.
• Roberts, N., Puddephat, M.J., McNulty, V. 2000. The benefit of stereology for quantitative radiology. Br. J. Radiol. 73,679-97.
• Sahin, B., Acer, N., Sonmez, O.F., Emirzeoglu, M., Basaloglu, H., Uzun, A., Bilgic, S. 2007. Comparison of four methods for the estimation of intracranial volume: a gold standard study. Clin. Anat. 20, 766-773.
• Sahin, B., Emirzeoglu, M., Uzun, A., Incesu, L., Bek, Y., Bilgic, S., Kaplan, S. 2003. Unbiased Estimation of the liver volume by the Cavalieri Principle using magnetic resonance images. Eur. J. Radiol. 47,164-170. Dicle et al.
• Sahin, B., Ergur, H. 2006. Assessment of the optimum section thickness for the estimation of liver volume using magnetic resonance images: A stereological gold standard study. Eur. J. Radiol. 57, 96-101.
• Schiano, T.D., Bodian, C., Schwartz, M.E., Glajchen, N., Min, A.D. 2000. Accuracy and significance of computed tomographic scan assess ment of hepatic volume in patients undergoing liver transplantation. Transplantation. 69, 545-550.
• Thompson, R.C. 2008. The taxonomy, phylogeny and transmission of echinococcus. Exp. Parasitol. 119, 439-446.
• Vogl, T.J., Trapp, M., Schroeder, H., Mack, M., Schuster, A., Schmitt, J. Neuhaus, P., Felix, R. 2000. Transarterial chemoembolization for he- patocellular carcinoma: Volumetric and morphologic CT criteria for assessment of prognosis and therapeutic success-results from a liver transplantation center. Radiology. 214, 349-357.
• Yamanaka, N., Okamoto, E., Kawamura, E., Kato, T., Oriyama, T., Fujimoto, J., Furukawa, K., Tanaka, T., Tomoda, F., Tanaka, W. 1993. Dy namics of normal and injured human liver regeneration after hepatectomy as assessed on the basis of computed tomography and liver func- tion. Hepatology. 18, 79-85.
• Zoli, M., Magalotti, D., Grimaldi, M., Gueli, C., Marchesini, G., Pisi, E. 1995. Physical examination of the liver: is it still worth it? Am. J. Gas- troenterol. 90, 1428-1432.