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脾脏巨大孤立性包虫囊肿——病例报告

Giant solitary hydatid cyst of spleen-A case report.

作者信息

Pukar M M, Pukar Shabari M

机构信息

Department of Surgery, Dr. Ulhas Patil Medical College and Hospital, Jalgaon, Maharashtra, India.

出版信息

Int J Surg Case Rep. 2013;4(4):435-7. doi: 10.1016/j.ijscr.2012.12.019. Epub 2013 Jan 23.

Abstract

INTRODUCTION

Primary hydatid disease of the spleen is very rare and even rarer to cause (any complication … pancreatitis.). Usually, splenic hydatid cysts are secondary, either resulting from spontaneous spread of cysts or occurring after operations involving hydatidosis in other regions. Here, we report a case of a primary isolated splenic hydatid cyst treated with a classical surgical approach. This case report and literature review describes the management of hydatid splenic invasion.

PRESENTATION OF CASE

We report the case of a 28-year-old female who presented with left hypochondriac non tender swelling/(mass). Abdominal ultrasonography and computed tomography (CT) revealed a cyst located in the spleen. The diagnosis was confirmed by a serological test. Surgical treatment involved a radical en bloc splenic resection (together with resection of the diaphragm and subcutaneous tissue.) The postoperative course was uneventful with three weeks of albendazole treatment. CT follow-up at six months demonstrated the absence of recurrence. Histopathologic examination revealed a hydatid cyst.

DISCUSSION

Complete aggressive surgical en bloc resection resection is the gold standard treatment of patients with hydatid cysts with the aim to remove all parasitic and pericystic tissues.

CONCLUSION

The infrequency with which it is encountered makes splenic hydatid disease a formidable early diagnostic challenge especially in nonendemic areas. Hydatid disease should be considered in the differential diagnosis of all cystic masses in the spleen/(abdomen), especially in the geographical regions where the disease is endemic.

摘要

引言

脾脏原发性包虫病非常罕见,导致(任何并发症……胰腺炎)的情况更为罕见。通常,脾包虫囊肿是继发性的,要么是囊肿自发扩散所致,要么是其他部位发生包虫病手术后出现。在此,我们报告一例采用经典手术方法治疗的原发性孤立性脾包虫囊肿病例。本病例报告及文献综述描述了包虫侵犯脾脏的治疗方法。

病例介绍

我们报告一例28岁女性患者,其表现为左季肋部无压痛性肿胀/(肿块)。腹部超声和计算机断层扫描(CT)显示脾脏有一个囊肿。血清学检查确诊了该诊断。手术治疗包括根治性整块脾切除术(连同膈肌和皮下组织切除术)。术后过程顺利,给予三周阿苯达唑治疗。六个月后的CT随访显示无复发。组织病理学检查显示为包虫囊肿。

讨论

彻底积极的整块手术切除是包虫囊肿患者的金标准治疗方法,目的是切除所有寄生组织和包囊周围组织。

结论

脾脏包虫病的罕见性使其成为一个严峻的早期诊断挑战,尤其是在非流行地区。在脾脏/(腹部)所有囊性肿块的鉴别诊断中都应考虑包虫病,特别是在该病流行的地理区域。

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