CASE REPORTS   

Chirurgia 2008 June;21(3):169-71

Copyright © 2008 EDIZIONI MINERVA MEDICA

language: English

Splenic hydatic cyst in the XI week of pregnancy. Acute onset as an abdominal emergency

BARELLINI L., PASCALE G., GIULIANI L.

Department of General Surgery Spedali Riuniti di Livorno, Livorno, Italy

Splenic hydatic cyst during pregnancy is a very rare event. Diagnosis is usually accomplished by ultrasonography or MR. Surgical treatment is controversial, in particular during pregnancy, because of the risk of rupture with anaphylactic reaction dissemination or recurrence. Furthermore, there is a limited experience in the medical management of hydatidosis during pregnancy. We report the case of 25 years old woman at her XI° week of pregnancy, admitted at our ward complaining of a severe abdominal pain. US scan revealed a 8 cm cystic mass adherent to the medial side of the spleen, suggestive for hydatic cyst.. A total splenectomy was accomplished without any cyst rupture. The post-operative stay was 7 days and the patient was discharged without any complication. Medical treatment with antihelmintic drugs (praziquantel, mebendazole) has been used by some Authors in diffuse hydatic disease, or in the case of recurrences. In our patient no medical treatment was administered. In fact the cyst was completely removed and there was no diffusion of the disease into the peritoneal cavity. These medication in pregnant patient may have adverse teratogenic effects. In conclusion splenic hydatic cyst during pregnancy is a very rare disease that can manifest with acute abdomen symptoms. It can be correctly diagnosed by ultrasonography and safely managed by complete surgical removal as in the present case.