Multimodal Treatment of a Spontaneously Ruptured Echinococcus Cyst of the Spleen and Its Complications

TL;DR

A patient with a ruptured hydatid cyst in the spleen was successfully treated with surgery and careful management of a dangerous side effect.

Contribution

This paper presents a rare case of splenic echinococcosis rupture and its treatment, emphasizing surgical and hypernatremia management.

Findings

Splenectomy and peritoneal lavage with hypertonic salt solution were used to treat a ruptured splenic hydatid cyst.

Hypernatremia following treatment was successfully managed with continuous venovenous hemofiltration.

Prompt surgical intervention is critical for survival in ruptured splenic echinococcosis.

Abstract

Introduction: Cystic echinococcosis, also known as hydatid cyst, is a parasitic infection of mammals that can affect any organ. Although the diagnosis of primary splenic echinococcosis is challenging, especially in nonendemic areas, it can be life-saving because an anaphylactic shock may occur when the cyst ruptures. Recommendations regarding optimal treatment options after rupture are scarce, and the overall prognosis remains poor.

Case Presentation: A patient with a spontaneous rupture of an isolated splenic hydatid cyst was treated with splenectomy and peritoneal lavage with a hypertonic salt solution. The patient survived despite rapidly progressive hypernatremia, which was treated with conventional therapy along with continuous venovenous hemofiltration with gradient sodium replacement.

Discussion: When the decision is made to treat a patient with a spontaneously ruptured splenic echinococcus cyst, splenectomy is the only surgical option. Hypernatremia is a complication to be expected when hypertonic saline is used to rinse the splenic and abdominal cavities.

Conclusion: This case highlights the importance of prompt surgical intervention and the management of hypernatremia in patients with ruptured splenic hydatid cysts.

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