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Surgery in children with hydatid disease of the spleen
Krassimira Kalinova1, Penka Stefanova, Mira Bosheva
1Department of General and Pediatric Surgery, High Medical School, Stara Zagora 6000, Bulgaria. krasimirakalinova@abv.bg
Insights
Hydatid disease of the spleen is rare in children, often diagnosed late, leading to splenectomy. Early diagnosis of splenic cysts is crucial for organ-preserving treatments.
Area of Science:
- Pediatric Surgery
- Parasitology
- Radiology
Background:
- Hydatid disease of the spleen is a rare condition, accounting for 1-8% of pediatric hydatid disease cases.
- Prevalence varies by socioeconomic status and geographic location.
- This study focuses on the diagnosis and treatment of splenic hydatidosis in children.
Purpose of the Study:
- To investigate the diagnostic methods and treatment outcomes for hydatid disease affecting the spleen in pediatric patients.
- To highlight the challenges in diagnosing splenic hydatid cysts due to their often asymptomatic nature.
Main Methods:
- A retrospective analysis of 152 children with hydatid disease operated on between 1985 and 2004.
- Detailed review of 15 pediatric cases with splenic hydatid disease, including patient demographics, cyst characteristics, and diagnostic modalities.
- Diagnostic tools included abdominal sonography, computed tomography (CT), and enzyme-linked immunosorbent assay (ELISA).
Main Results:
- Of 152 children, 15 (9.87%) had splenic hydatid disease, aged 10-18 years.
- Spleen cysts were often solitary and asymptomatic, with 7 cases involving other organs.
- Splenectomy was performed in 14 out of 15 cases; cystectomy was successful in only one case. Organ-preserving techniques were used in combined forms.
Conclusions:
- Splenic hydatid disease lacks specific clinical signs, leading to delayed diagnosis and frequent splenectomy.
- Early diagnosis, suspected in patients with splenic cysts and confirmed by imaging (ultrasonography, CT, MRI) and serology, is essential.
- Prompt diagnosis improves the feasibility of organ-preserving surgical interventions.
Background/Purpose:
Hydatid disease of the spleen is a rare disease, and it occurs in 1% to 8% of all children with hydatid disease. That difference in frequency depends on the social and economic status of the patients and the country. The aim of our study is to reveal its diagnosis and treatment.
Methods:
From 1985 to 2004, 152 children with hydatid disease have been operated on at the Surgical Department of General and Pediatric surgery at the Medical University in Stara Zagora and Medical University in Plovdiv, Bulgaria. Of the 152 children, 15 (9.87%) had spleen localization: 6 males and 9 females, aged 10 to 18 years. A solitary cyst in the spleen was found in 10 patients, 8 children had an isolated cyst only in the spleen, 7 with involvement of other organs (5 in the liver, 2 in liver and lungs). All spleen cysts were "silent." Abdominal sonography, computed tomography, and enzyme-linked immunosorbent assay tests proved the diagnosis. All children were operated on.
Results:
A splenectomy was performed in 14 cases, and a cystectomy was possible in only 1 case. Patients with combined forms successfully underwent different variations of cystectomy: 6 omentoplasty, 5 capitonnages, and 4 invaginations.
Conclusions:
Splenic involvement of hydatid disease has no specific clinical manifestation, the diagnosis is late and often leads to splenectomy. Organ-preserving procedures are possible only in cases with early diagnosis. It has to be suspected in a patient with a splenic cyst and has to be confirmed by ultrasonography and/or computed tomography, magnetic resonance imaging, and immunologic tests. The early diagnosis is a good precondition for better results.
