Belli Sedat, Akbulut Sami, Erbay Gürcan, Koçer Nazım Emrah
Department of General Surgery, Diyarbakır Education and Research Hospital, Diyarbakır, Turkey.
Turk J Gastroenterol. 2014 Feb;25(1):88-91. doi: 10.5152/tjg.2014.3521.
Hydatid disease is a parasitic infection characterized by cyst formation in any organ, although the liver and lungs are most commonly involved. Hydatid disease of the spleen is uncommon, representing <8% of all human hydatid diseases. Splenic hydatid cysts usually coexist with liver hydatid cysts (secondary form), although the spleen is the primary location (primary form) in some cases. The clinical signs and symptoms of splenic hydatid cysts depend on their size, relationship with adjacent organs, and complications. One of the complications of splenic hydatid cysts is cyst rupture either after trauma or spontaneously as a result of increased intracystic pressure. These cysts may rupture into a hollow organ, through the diaphragm into the pleural cavity, or directly into the peritoneal cavity. A splenic hydatid cyst that ruptures into the peritoneal cavity may cause complications, including signs of peritoneal irritation, urticaria, anaphylaxis, and death, as in our case. Therefore, a hydatid cyst rupture requires both emergency surgery and careful postoperative care. In this study, we present a case of a giant splenic hydatid cyst that ruptured into the peritoneal cavity without any trauma. A review of cases reported in the English literature about splenic hydatid cyst perforation is also discussed.
包虫病是一种寄生虫感染，其特征是在任何器官中形成囊肿，不过最常累及肝脏和肺。脾脏包虫病并不常见，占所有人类包虫病的比例不到8%。脾包虫囊肿通常与肝包虫囊肿共存（继发形式），不过在某些情况下脾脏是主要发病部位（原发形式）。脾包虫囊肿的临床体征和症状取决于其大小、与相邻器官的关系以及并发症。脾包虫囊肿的并发症之一是囊肿破裂，可发生于外伤后或因囊内压力升高而自发破裂。这些囊肿可能破入中空器官，穿过膈肌进入胸腔，或直接破入腹腔。如我们病例中所示，破入腹腔的脾包虫囊肿可能会引起包括腹膜刺激征、荨麻疹、过敏反应甚至死亡等并发症。因此，包虫囊肿破裂需要紧急手术及术后精心护理。在本研究中，我们报告了一例巨大脾包虫囊肿在无任何外伤情况下破入腹腔的病例。同时还讨论了英文文献中报道的脾包虫囊肿穿孔病例的回顾。
