Primary splenic hydatid cyst treated with laparoscopic spleen preserving surgery: A case report

BACKGROUND: Primary splenic hydatidosis is an uncommon etiology. Total splenectomy has been the treatment of choice, however, spleen preserving surgery has been gaining popularity. CASE REPORT: We present a case of a 52-year-old man who was evaluated for a splenic cyst, found incidentally on CT scan done at another institution. MRI was repeated in our institution along with an indirect hemagglutination test to confirm the diagnosis. Since our patient had a single non-complicated cyst confined to the spleen’s lower pole, we decided to opt for laparoscopic cyst unroofing and omentoplasty, a spleen preserving technique. DISCUSSION: Due to the rarity of splenic hydatidosis, no strict management guidelines are available, and the decision is usually left for the surgeon. Total splenectomy has been considered the standard of care, however, spleen preserving surgical techniques and percutaneous interventions have been suggested as better alternatives. Spleen preserving techniques lead to surgical outcomes comparable to total splenectomy, with the added benefit of preserving the immunological protection provided by the spleen and protecting patients from dramatic complications that might follow total splenectomy, such as overwhelming post-splenectomy infections, which are associated with very high mortality. CONCLUSION: Laparoscopic cyst unroofing and omentoplasty is a feasible surgical technique to treat primary splenic hydatidosis while preserving the spleen’s immunologic function.