Hepatic and Splenic Hydatidosis Managed with Percutaneous Aspiration, Injection, and Reaspiration (PAIR) of the Hepatic Cyst and Laparoscopic Splenectomy

• Published in: Journal of gastrointestinal surgery Vol. 12; no. 9; pp. 1615 - 1617
• Main Authors: Marco Fisichella, P., Donaldson, Kristen, Scott Helton, W.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01-09-2008; Springer Nature B.V
• Subjects: Adult; Animals; Antiprotozoal Agents - therapeutic use; Cholangiopancreatography, Endoscopic Retrograde; Combined Modality Therapy; Cysts; Echinococcosis - diagnostic imaging; Echinococcosis - therapy; Echinococcosis, Hepatic - diagnostic imaging; Echinococcosis, Hepatic - therapy; Female; Follow-Up Studies; Gastroenterology; GI Image; Humans; Laparoscopy - methods; Medicine; Medicine & Public Health; Risk Assessment; Severity of Illness Index; Splenectomy - methods; Splenic Diseases - diagnostic imaging; Splenic Diseases - therapy; Suction - methods; Surgery; Tomography, X-Ray Computed; Spleen; Echinococcus; Hydatid disease; Cysts; Liver; Laparoscopy; PAIR
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-007-0419-1

The treatment of hydatidosis traditionally consisted of surgery with a perioperative course of anthelmintic medications. However, percutaneous aspiration, injection, and reaspiration (PAIR) combined with oral albendazole has been recently shown to be as effective as surgery in the treatment of liver hydatidosis. We report a 20-year-old female immigrant from Western Europe who presented with discomfort in her upper abdomen. Computed tomography revealed a 5.7 × 7 × 5.9-cm cyst in segment 7 of the liver and a 17 × 15-cm cyst in the spleen in contiguity with the hilar vessels. Indirect hemaglutination test confirmed hydatidosis. A strategy with two different surgical approaches was designed to treat her condition: laparoscopic splenectomy and ultrasound-guided PAIR of the liver cyst. The patient was discharged on postoperative day 5, and at 18 months follow-up, she is free of symptoms.