Anaphylaxis due to spontaneous rupture of primary isolated splenic hydatid cyst
A 57-year-old woman was admitted to the emergency department for diffuse maculopapular rashes on the whole body and anaphylactic shock. She had been complaining of sudden- onset of abdominal pain, dyspnea, pruritus, and urticaria. On physical examination, it revealed tenderness, guarding, and rigidity all over the abdomen. Her blood pressure was 90/60 mmHg, heart rate 118/min, and temperature 37.0°C. Blood test analysis was normal and subsequent leucocytosis with eosinophil dominance. Hydration, hydrocortisone, and antihistamines were used to treat the possible anaphylactic reaction. The patient received oxygen as supportive treatment. The patient recovered after emergency medications and then abdominal computed tomography (CT) revealed a splenic cystic lesion measuring about 9’ 6 cm2 in diameters and containing floating membranes. The anterior wall of the cyst showed discontinuity at a point []. Diffuse pelvic and minimal perisplenic fluid were detected. Our fundamental concerns were to preserve the spleen. Then, the patient underwent a laparoscopic partial cystectomy and omentoplasty, since the spread of the disease into the peritoneal cavity of lesions was strong contraindications for a radical surgical approach. At the time of laparotomy, the cyst's outer membrane was seen ruptured []. The postoperative course was uneventful, and the patient was discharged 10 days after the surgery. We applied albendazole, 10 mg/kg/day for 6 months, and the patient was followed up with CT that displayed no recurrence of the disease during a follow-up of 6 months []. She is still symptom-free in the 12-month follow-up.