Sah Rajan Kumar, Sah Biki Kumar, Dang Chau Thi Minh, Sah Vivek Kumar
Manipal College of Medical Sciences, Pokhara, Nepal.
B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Ann Med Surg (Lond). 2022 Nov 14;84:104863. doi: 10.1016/j.amsu.2022.104863. eCollection 2022 Dec.
and importance: Hydatid cyst disease is caused by Echinococcus tapeworm and is one of the major health problems in endemic regions like Nepal. The cases of splenic hydatidosis are quite rare and giant isolated primary splenic hydatidosis is even rarer. The patients present with vague symptoms or no symptoms at all. Here we report a case of isolated splenic hydatid cyst. So, we should think the differential diagnosis of splenic hydatidosis in any abdominal case of endemic regions.
A 27-year-old female presented with left-side abdominal pain for the past 7 months without any particular attraction. Abdominal ultrasound showed a well-defined cystic mass on the upper pole with low-level internal floating debris. Contrast Enhanced CT scan showed well defined cystic lesion measuring about 10.8 × 9.6 × 8.5 cm in the upper pole of the spleen with an exophytic component and minimal homogenous wall enhancement. Laparoscopic Splenectomy was done and albendazole for 3 weeks was prescribed after all the patient was completely normal.
In this case, the optimal treatment of giant isolated splenic hydatidosis was splenectomy and prescription of albendazole.
We believe in any abdominal case of the endemic region, the hydatid cyst of the spleen should be taken as one of the differential diagnoses and should be managed appropriately before the complication arises.
及其重要性:包虫囊肿病由棘球绦虫引起,是尼泊尔等流行地区的主要健康问题之一。脾包虫病病例相当罕见,巨大孤立性原发性脾包虫病更为罕见。患者表现为症状模糊或根本没有症状。在此,我们报告一例孤立性脾包虫囊肿病例。因此,在流行地区的任何腹部病例中,我们都应考虑脾包虫病的鉴别诊断。
一名27岁女性,在过去7个月里一直感到左侧腹痛,无任何特殊诱因。腹部超声显示脾上极有一个边界清晰的囊性肿块,内部有低水平浮动碎片。增强CT扫描显示脾上极有一个边界清晰的囊性病变,大小约为10.8×9.6×8.5厘米,有一个外生性成分,囊壁均匀强化轻微。进行了腹腔镜脾切除术,并在患者完全康复后开了3周的阿苯达唑。
在本病例中,巨大孤立性脾包虫病的最佳治疗方法是脾切除术和阿苯达唑治疗。
我们认为,在流行地区的任何腹部病例中,脾包虫囊肿都应作为鉴别诊断之一,应在并发症出现之前进行适当处理。