Diagnostic and Therapeutic Strategy in the Management of Hydatid Cysts of the Spleen: About 12 Cases

Introduction: Splenic hydatidosis is a rare clinical entity, yet the spleen is the third most affected organ after the liver and lungs.

Objectives: The aim of our work is to study the epidemiological, clinical and paraclinical characteristics as well as the place of medical, instrumental (percutaneous), radical surgical and conservative surgical treatments of splenic hydatidosis.

Materials and Methods: Our work is a retrospective study with a descriptive aim concerning 12 cases operated for splenic hydatid cysts within the department of general surgery (wing 3) of CHU Ibn Rochd in Casablanca over a period of 5years, from January 2010 to December 2014.

Results: The average age of our patients was 43 years, with a female predominance of 58.33%, the origin of our patients was rural in 66.67% of cases, the history of surgery for hydatid cyst was found in 66.66% of cases.75% of our patients consulted for pain in the left hypochondrium.

Abdominal ultrasound and computed tomography (CT) scan were realized for all our patients and confirmed the cystic nature and splenic location of the cysts. They were unique in 75% of cases and associated with other hydatid localizations in 33.33% of cases.

Hydatid serology (indirect hemagglutination) was conducted on 75% of the patients and was positive in only 25% of cases.

Surgical treatment was performed in all patients, resection of the protruding dome was the most used method (58.33% of cases) followed by total splenectomy (41.67% of cases).

Conclusion: Abdominal ultrasound represents the key examination for diagnosis. Surgery is the gold standard of treatment.