Department of Hepatobiliary Surgery, Dazhou Central Hospital, Sichuan Province, China.
Department of Pathology, Dazhou Central Hospital, Dazhou, Sichuan Province, China.
Am J Trop Med Hyg. 2019 Oct;101(4):821-827. doi: 10.4269/ajtmh.19-0400.
Cystic echinococcosis (CE), also known as hydatid cyst, is a zoonosis caused by the tapeworm . It is a common health problem in many countries. This condition predominantly affects the liver and the lungs, and the spleen to a less extent (splenic hydatid cyst, SHD). Indeed, it is estimated that SHD occurs in less than 2% of abdominal CE and 0.5-8% of CE cases. Here, we present a case of a 44-year-old Chinese woman with primary giant SHD who experienced pain in the left hypochondrium for 10 days. A combination of abdominal ultrasonography and computed tomography (CT) were used for preoperative diagnosis. Laparoscopic splenectomy was performed without any complications, and albendazole (400 mg per day) was administered postoperatively for 3 months. At 3-, 6-, 12-, and 24-month follow-up, the patient remained symptoms free, and abdominal CT found no signs of recurrence. In addition to this case, we review the previous literature on SHD treated by laparoscopy and reveal that laparoscopic approach is safe and effective for SHD. Particularly, we show that laparoscopic splenectomy is feasible for giant cysts (> 10 cm) at high risk of rupture or compressing other vital structures.
包虫病（CE）又称棘球蚴病，是一种由绦虫引起的人畜共患疾病。它是许多国家的常见健康问题。这种疾病主要影响肝脏和肺部，脾脏次之（脾包虫囊肿，SHD）。事实上，据估计，SHD 发生在不到 2%的腹部 CE 和 0.5-8%的 CE 病例中。在这里，我们报告了一例 44 岁的中国女性，患有原发性巨大 SHD，左季肋部疼痛 10 天。术前诊断采用腹部超声和计算机断层扫描（CT）相结合的方法。腹腔镜脾切除术无任何并发症，术后给予阿苯达唑（每天 400mg）治疗 3 个月。在 3、6、12 和 24 个月的随访中，患者无任何症状，腹部 CT 未发现复发迹象。除了这个病例，我们还回顾了之前关于腹腔镜治疗 SHD 的文献，并发现腹腔镜方法对 SHD 是安全有效的。特别是，我们表明腹腔镜脾切除术对于有破裂高风险或压迫其他重要结构的巨大囊肿（>10cm）是可行的。
