Splenic hydatid cyst perforating into the colon manifesting as acute massive lower gastrointestinal bleeding: an unusual presentation of disseminated abdominal echinococcosis

Teke Z, Yagci AB, Atalay AO, Kabay B
Correspondence: Dr Zafer Teke, zteke_md@yahoo.com; zteke_md@hotmail.com

ABSTRACT
Hydatid disease can occur in all viscera and soft tissues, although the liver and the lungs are the organs most commonly involved. Isolated splenic involvement with the disease is extremely rare. Splenic hydatid cysts may suppurate, fistulise to adjacent organs, or rupture into the peritonaeal cavity. However, acute, massive lower gastrointestinal bleeding due to splenocolic communication resulting from splenic echinococcal cyst has not been previously reported. We present a 77-year-old woman with disseminated abdominal echinococcosis, and active lower gastrointestinal bleeding due to splenocolic fistula resulting from splenic hydatid cyst. She was treated successfully with en-bloc excision of the spleen and splenic flexure of the colon.

Keywords: echinococcosis, gastrointestinal bleeding, hydatid cyst, hydatid disease, splenic hydatidosis, splenocolic fistula
Singapore Med J 2008; 49(5): e113-e116