Splenic hydatid cyst

Case contributed by Dr Badis Al Harbawi

Presentation

Left upper quadrant pain

Patient Data

Age: 35 years
Gender: Male
ultrasound

A thin-walled anechoic cyst is seen superomedial to the spleen, which appears to communicate with an intrasplenic well-defined lobulated hypoechoic lesion. 

Abdominal CT scan with IV contrast

ct

There is a large cystic lesion measuring about 7.2 x 6.8 x 5 cm in the left upper abdomen anteriorly between the stomach and the spleen causing compression of the gastric fundus. Fat stranding is seen around the distal aspect of this lesion.

The mentioned cystic lesion appears to communicate with a lobulated cyst/cavity measuring about 3.8 x 3.4 x 2.5 cm at the anterior aspect of the spleen. 

No calcifications are seen in the mentioned cystic lesion. Faint marginal enhancement is seen in the splenic component of the cystic lesion. 

No liver cysts. No abdominal masses, enlarged lymph nodes, or free fluid collection. 

pathology

Intraoperative photo and histopathology report confirm that the described splenic and parasplenic cystic lesion is a hydatid cyst. 

Case Discussion

This case represents an intraoperative and pathologically proven splenic hydatid cyst.

Hydatid cyst of the spleen is a rare entity, especially when isolated to the spleen, accounting for about 4 % of abdominal hydatid disease. Radiological findings are similar to those of liver hydatid cysts, ranging from cystic to solid appearance and from a unilocular cyst to multivesicular cyst. Calcifications in the cyst wall may occur.

Patients are usually asymptomatic, but when the cyst reaches considerable size patients may develop symptoms like abdominal pain, enlarged spleen, fever, and a palpable mass.

Complications include:

  • rupture
  • infection
  • fistulisation with adjacent structures
  • anaphylaxis

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