Merad Yassine, Derrar Hichem, Zeggai Ahmed, Chadli Mohammed, Bemrah Nabil, ElHabachi Boumediene
Department of Parasitology-Mycology, Central Laboratory, « Hassani Abdelkader » Hospital, University, UDL Faculty of Medicine, Sidi-Bel Abbès, Algeria.
Laboratory of Environmental Information Synthesis, Djillali Liabes University, Sidi-bel-Abbes, Algeria.
Ann Med Surg (Lond). 2021 Apr 20;65:102293. doi: 10.1016/j.amsu.2021.102293. eCollection 2021 May.
Hydatid disease is endemic in farming areas but occurs worldwide. The most common site of disease is liver. Hydatid disease of the spleen is a rare condition. Worldwide incidence of splenic hydatid is 0.5-4%. Surgery is the mainstay of treatment. The standard treatment is open total or partial splenectomy.
A 28 year-old female patient was referred to our institution, after coincidental sonography finding. On abdominal examination, there was no sensitization, and there was no resistance or rebound.Ultrasound showed an enlarge spleen; an abdominal CT confirmed the presence of a splenic cyst at the lower pole of the spleen of 7 cm in diameter, no other organ involvement. The biological confirmation was made by indirect hemagglutination. Spleen-sparing surgery was performed. Macroscopic and microscopic examination of the specimen confirmed Hydatid cyst. The patient was discharged from hospital on the seventh postoperative day with a prescription for albendazole (2 × 400 mg/day) for three months.
The rarity of primary splenic hydatid disease poses a diagnostic challenge for clinicians, the disease should be considered in differential in every patient in endemic areas with cystic lesion of spleen until proved otherwise, it may be detected incidentally or present with non-specific complaints, preservation surgery should always be tried to avoid post splenectomy infection, especially in young patients.
包虫病在农业地区为地方病，但在全球范围内均有发生。最常见的发病部位是肝脏。脾脏包虫病是一种罕见病症。全球脾包虫病的发病率为0.5% - 4%。手术是主要的治疗方法。标准治疗是开放性全脾或部分脾切除术。
一名28岁女性患者经偶然的超声检查发现后转诊至我院。腹部检查无压痛，无抵抗或反跳痛。超声显示脾脏肿大；腹部CT证实脾脏下极存在一个直径7厘米的脾囊肿，无其他器官受累。通过间接血凝试验进行生物学确诊。实施了保脾手术。对标本进行的宏观和微观检查证实为包虫囊肿。患者术后第七天出院，开具了阿苯达唑（2×400毫克/天）的处方，服用三个月。
原发性脾包虫病的罕见性给临床医生带来了诊断挑战，在脾部有囊性病变的地方病流行地区，每一位患者在鉴别诊断时都应考虑该病，除非另有证实，该病可能偶然被发现或表现为非特异性症状，应始终尝试进行保留脾脏的手术以避免脾切除术后感染，尤其是在年轻患者中。
