Kismet Kemal, Ozcan Ali Haldun, Sabuncuoglu Mehmet Zafer, Gencay Cem, Kilicoglu Bulent, Turan Ceyda, Akkus Mehmet Ali
Ankara Training and Research Hospital, 4th General Surgery Department, Turkey.
World J Gastroenterol. 2006 Apr 28;12(16):2633-5. doi: 10.3748/wjg.v12.i16.2633.
Hydatid disease is caused by the larval stage of the genus Echinococcus. Live hydatid cysts can rupture into physiologic channels, free body cavities or adjacent organs. Although hydatid disease can develop anywhere in the human body, the liver is the most frequently involved organ, followed by the lungs. Cysts of the spleen are unusual. There are only five case reports of spontaneous cutaneous fistulization of liver hydatid cysts in the literature. But there isn't any report about cutaneous fistula caused by splenic hydatid cyst. We report a first case of spontaneous cutaneous fistula of infected splenic hydatid cyst. A 43-year-old man was admitted to our Emergency Service with abdominal pain and fluid drainage from the abdominal wall. He has been suffering from a reddish swelling on the abdominal wall skin for four months. After a white membrane had been protruded out from his abdominal wall, he was admitted to our Emergency Service. On physical examination, a white membrane was seen to protrude out from the 2 cm x 1 cm skin defect on the left superolateral site of the umblicus. Large, complex, cystic and solid mass of 9.5 cm-diameter was located in the spleen on ultrasonographic examination. At operation, partial cystectomy and drainage was performed. After the operation, he was given a dosage of 10 mg/kg per day of albendazole, divided into three doses. He was discharged on the postoperative 10(th) d. It should be kept in mind that splenic hydatid cysts can cause such a rare complication.
包虫病由棘球绦虫属的幼虫阶段引起。活的包虫囊肿可破裂进入生理通道、游离体腔或邻近器官。尽管包虫病可在人体任何部位发生,但肝脏是最常受累的器官,其次是肺。脾囊肿较为罕见。文献中仅有5例肝包虫囊肿自发性皮肤瘘的病例报告。但尚无脾包虫囊肿引起皮肤瘘的报告。我们报告首例感染性脾包虫囊肿自发性皮肤瘘病例。一名43岁男性因腹痛和腹壁引流液入住我院急诊科。他的腹壁皮肤出现红色肿胀已有4个月。在腹壁有白色膜状物突出后,他入住了我院急诊科。体格检查时,可见脐左上外侧2 cm×1 cm皮肤缺损处有白色膜状物突出。超声检查发现脾脏有一个直径9.5 cm的大的、复杂的、囊实性肿块。手术时,进行了部分囊肿切除术和引流。术后,给予阿苯达唑10 mg/kg/d的剂量,分三次服用。他于术后第10天出院。应记住,脾包虫囊肿可引起这种罕见的并发症。