Surgical treatment for splenic hydatidosis

Splenic involvement is rare in patients with hydatid disease even in endemic countries. The spleen is the third most commonly involved organ after the liver and the lung. In our series splenic echinococcosis represents 5.8% of abdominal hydatid disease. During the last 22 years, 14 patients were operated on for splenic hydatid cysts in our department. In 10 patients the spleen was the only location of hydatid disease; in 2 patients there was concomitant liver hydatid disease; one patient had disseminated intraabdominal disease; and one patient had a coexisting hydatid cyst in the quadriceps femoris muscle. Plain abdominal films, ultrasonography, and computed tomography scans were most useful for establishing the diagnosis. All patients underwent splenectomy alone or combined with management of cysts at other sites, except for two patients who underwent omentoplasty and one patient who underwent external drainage. One patient died during the early postoperative period (mortality rate 7%), and three patients had minor complications. Splenic hydatid disease should be included in the differential diagnosis when a splenic cyst is identified, especially in patients with a history of hydatid disease. Surgery remains the treatment of choice to avoid serious complications.