CASE REPORT: PRIMARY SPLENIC HYDATID CYST

Bilal Ahmad WaniMohammad Ashraf KhanTanish Baweja^*Omar Javed ShahArushi SumraniTajamul Rashid

• Hamdard Institute of Medical Sciences and Research (HIMSR), New Delhi, India

Introduction- Primary splenic hydatidosis accounts for <2% of global cystic echinococcosis cases. Its rarity and nonspecific clinical presentation often lead to delayed diagnosis, posing a risk of severe complications. This case is noteworthy because early clinical suspicion, despite subtle symptoms, enabled prompt diagnosis and successful treatment. It highlights the importance of maintaining a broad differential when evaluating unexplained abdominal pain, particularly in endemic regions. By presenting this case alongside a focused review of the literature, we aim to raise awareness and offer practical guidance for clinicians faced with similar diagnostic challenges. Case Presentation- A 23-year-old female presented with chronic pain in the left upper quadrant of the abdomen, accompanied by nausea, vomiting, and low-grade fever. Splenomegaly was noted on physical examination. Given the clinical presentation, a splenic hydatid cyst was considered among the differential diagnoses. Abdominal ultrasonography (USG) and computed tomography (CT) revealed a solitary cystic lesion in the spleen without calcification or solid components. Serological testing with enzyme immunoassay for IgG (Immunoglobulin G) and IgE (Immunoglobulin E) antibodies was positive for echinococcosis. Due to the large size of the cyst and risk of rupture, a total splenectomy was performed. Histopathological examination of the resected specimen confirmed the diagnosis of a hydatid cyst. The postoperative course was uneventful, and the patient continues to do well on regular outpatient follow-up. Conclusion- This case highlights that splenic hydatid cysts, though uncommon and often presenting with non-specific symptoms, should be considered in the differential diagnosis of abdominal pain, especially in endemic regions. Early diagnosis through the combined use of imaging and serological tests is essential for effective clinical management. Surgical intervention, based on the cyst's size and risk of rupture, can result in excellent outcomes. This case underscores the need for heightened clinical suspicion in endemic regions to mitigate delays in diagnosis.