Primary Hydatic Cyst of the Spleen

Abstract

A 87 years old woman, natural and from a rural area of the province of Cordoba, Spain. Personal history of depressive disorder (treated with lorazepam, bupropion, triazolam and escitalopram), hypertension and transient ischemic attack 10 years ago (in treatment with acetylsalicylic acid) and advanced glaucoma for 4 years (treated with latanoprost and timolol). Visits with abdominal pain of insidious onset, diffuse, intermittent, with a month of evolution, located in the stomach region without irradiation, associated with nausea and intermittent vomiting. Patient refers long-standing loss of appetite. She denies urinary clinic. The last deposition was 2 days ago, with usual constipated habit. During the clinical examination she maintains its stable vital functions and remains conscious and oriented. The abdomen is soft and depressible, tenderness in the stomach region to touch without mass or organ enlargement or peristalsis. The rest of the exam without significant alterations. The blood count values are: hemoglobin 16.7, VCM 85.7, HCM 28, platelets 302,000, 11,000 leukocytes, neutrophils 78.2%, 16.4% lymphocytes and eosinophils 0.5%. Biochemical values are within normal parameters. In the posteroanterior and lateral chest radiographs (Figures 1 and 2) can be seen a nodular lesion with left infradiaphragmatic peripheral calcification. In plain abdominal radiography (Figure 3) abundant stool and gas in the colon, distal presence of gas are evident; the presence of a round 5 cm in diameter calcified lesion, located in the left upper quadrant is confirmed. It is given metamizol, metoclopramide and ranitidine in 100 ml of physiological saline and 0.5 mg sublingual alprazolam. Clinical response is favorable and the pain disappears. Home treatment consists ina soft laxative diet regimen, chamomile tea, rectal enema to achieve effectiveness, and she is referred to his family physician for control. A month later, the patient was referred to a doctor specialist in digestive