Ozlem Nuraydin
Samsun Education and Research Hospital Turkey, General Surgery Department, Turkey.
Int J Surg Case Rep. 2015;7C:112-4. doi: 10.1016/j.ijscr.2014.10.092. Epub 2014 Nov 4.
Hydatid cyst (HC) can be observed in all parts of the body, splenic involvement represents 5% of all cases. Many ruptured HC's cases of a primary organ have been reported in the literature. However, only several splenic HC rupture has reported. A patient with traumatic rupture of splenic hydatic cyst is presented.
37 year old female sustained traffic accident presented our emergency department. In her physical examination there was hemodynamic instability, peritoneal irritation sign. An ultrasonographic examination of her abdomen showed intraperitoneal free fluid, a splenic rupture. The patient urgently operated; a 11×9×5cm ruptured HC in the spleen was treated by splenectomy. During surgery the intraabdominal spaces were washed with povidoniodine and saline. Postoperative course of the patient was uneventful. The spleen was an organ involved with hydatidosis in our patient. Pathologic examination of the specimen revealed a splenic hydatid cyst. The patient is symptom free for 18 months.
Several traumatic ruptured splenic HC case are encountered in the literature. The cases in the literature almost always are not case report but those are one or more than one case in a case series. This case, an extremely infrequent encountered is reporting.
Early discovery is important since it is possible to cure viable HCs without dissemination to other organs by conservative surgery. If our patient was examined by ultrasound in a routine check up then her hydatid cyst of spleen would be discovered, the treatment of it would be made so no peritoneal dissemination with cystic fluid will be occur.
包虫囊肿(HC)可见于身体的各个部位,脾脏受累占所有病例的5%。文献中已报道了许多原发性器官的包虫囊肿破裂病例。然而,仅有几例脾脏包虫囊肿破裂的报道。本文介绍了一名脾包虫囊肿外伤性破裂的患者。
一名37岁女性因交通事故被送至我院急诊科。体格检查发现其血流动力学不稳定,有腹膜刺激征。腹部超声检查显示腹腔内有游离液体,脾脏破裂。患者紧急接受手术;脾脏内一个11×9×5cm的破裂包虫囊肿通过脾切除术进行治疗。手术过程中,用聚维酮碘和生理盐水冲洗腹腔。患者术后恢复顺利。在我们的患者中,脾脏是受累于包虫病的器官。标本的病理检查显示为脾包虫囊肿。患者18个月来无症状。
文献中遇到了几例外伤性脾包虫囊肿破裂病例。文献中的病例几乎都不是病例报告,而是病例系列中的一个或多个病例。本文报告了这一极为罕见的病例。
早期发现很重要,因为通过保守手术有可能治愈存活的包虫囊肿而不扩散到其他器官。如果我们的患者在常规体检中接受超声检查,那么她的脾包虫囊肿就会被发现,并进行治疗,这样就不会发生囊肿液的腹膜播散。