Ghulam Mustafa Arain, Ghulam Mustafa Arain, Safdar Ali Malik.
Hydatid Cyst of the Spleen.
Pak J Gastroenterol Nov ;12(1-2):0-.

Splenic hydatid disease is rare. Its incidence is 1-5% of all cases of hydatid disease. It is a rare causes of splenornegaly presenting as mass in right hypochondrium and anemia. Ultrasound of abdomen and compliment fixation test are main stay of diagnosis. Splenectomy is procedure of choice in adults while in children splenic salvage is recommended. Postoperatively albendazole is used to reduce recurrence.

A 51 year old male presented in surgical unit-3 through out patient department with a painful swelling in left hypochondrium for 1 year. Initially swelling was small and painless, but then it progressed slowly. On clinical examination, swelling was extending from left hypochondrium upto umbilicus. It was well defined, smooth and non tender. It moved with respiration vertically but it was not mobile form side to side. Fingers could not be passed below left subcostal margin. Liver was not palpable. Clinical diagnoses of splenomegaly was made. Hb was 10g%, eosinophils 8% and ESR 25 mm / 1st hour. Compliment fixation test was positive. On ultrasound examination unilocular cyst of size 16 cm x 25 cm occupying spleen was demonstrated. Thus diagnosis of hydatid cyst of spleen was made. At laparotomy the viscerae were isolated with packs soaked in 10% hypertonic saline. About 500ml pale looking fluid was aspirated from cyst and then 100ml of hypertonic 10% saline was injected. Spillage was avoided carefully. Splenectomy was done and then cyst opened. It contained, fluid, hydatid sand, daughter cysts and laminated membrane. Wound was closed without drain. Postoperatively patient was put on Albendazole 500mg BD for 3 months. Biopsy report confirmed the diagnosis of hydatid cyst.

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