Traumatic rupture of a solitary splenic hydatid cyst: A case report

Abstract

The rupture of an Echinococcus granulosus hydatid cyst in the spleen due to trauma is a rare event. In this case report we describe the case of a 39-year-old Lebanese male victim of a motor vehicle accident with a ruptured solitary splenic hydatid cyst discovered by CT scan and excised during exploratory laparotomy. Echinococcosis or hydatid disease is a parasitic infestation by the Echinococcus genus of tapeworm. The eggs of E. granulosus, a species of Echinococcus, are fecal-orally transmitted to human hosts, most often from dog feces, and manifest as cystic lesions termed hydatid. E. granulosus most commonly affects the liver (75%), lungs (15%), and rarely the spleen (2-5%) [1], [2]. E. granulosus is particularly endemic to cattle rearing areas of the Middle East. Infected patients most commonly present with vague abdominal pain, as a result of mass effect or spontaneous rupture of the cyst. Nevertheless, patient presentation may be due to traumatic rupture of a hydatid cyst; however, this is very rare. Herein we report a case of traumatic rupture of a solitary splenic hydatid cyst in a 39-year-old male following a motor vehicle crash, managed following the Advanced Trauma Life Support (ATLS) protocol.

Keywords: Cysts; Echinococcus; Hydatid; Splenectomy; Surgery; Trauma.

Fig. 1

Abdominopelvic computed tomography scan reveals a large cystic mass originating from the spleen. Increased central intensity is noted that is indicative of active hemorrhage into a pre-existing splenic cyst or a large pseudoaneurysm.

Fig. 2

Intra-operative image of the ruptured solitary splenic cyst.