Splenik hidatik kist cerrahisinde anafilaktik şok: Olgu sunumu

Öz

Hidatik hastalık Echinococcus granulosus'un neden olduğu yaygın bir parazit enfeksiyonudur. İzole splenik tutulum endemik bölgelerde bile nadir bir durumdur. Dalak kist hidatiklerinin tedavisi çoğunlukla cerrahi yöntemdir. Anafilaktik şok gibi cerrahi sırasında komplikasyonlar görülebilir. Burada, splenik kist hidatik için hastanemize yatırılan bir olgu sunulmuştur. Hasta 31 yaşındaydı. Sol hipokondride mütevazı bir ağrı nedeniyle başvurdu. Karın muayenesinde sol hipokondri ve epigastrik bölgelerde hafif hassasiyet vardı. Hepatomegali bulunamadı. Abdominal bilgisayarlı tomografide, çapları 8 cm, çapları 2 cm olan ve yüzer membranlar içeren, izole splenik kistik lezyon izlendi. Hasta ameliyat edildi ve sol subkostal kesi yapıldı. Cerrahi incelemede, splenik parankima orta bölgesini işgal eden hidatik bir kist ortaya çıkmış, üst ve alt yüzeyde sadece ince bir tabaka splenik doku mevcuttu. Ameliyatın sonunda hasta taşikardi, hipotansiyon ve yaygın cilt eritemi oluştu. Sonuçta hemodinamik istikrarsızlık, spesifik tedaviye başlanabilmesi için anafilaksi teşhisi konmalıdır, anafilaksi şiddeti nedeniyle tüm önleyici tedbirler alınmalıdır.

Anahtar Kelimeler

• Anafilaktik şok,Kist hidatik,Önleme,Cerrahi

Anaphylactic shock during splenic hydatid cyst surgery: A case report

Abstract

Hydatid disease is a common parasitic infection caused by Echinococcus granulosus. Isolated splenic involvement is an uncommon condition even in endemic regions. The treatment of a splenic hydatid cyst is mainly surgical. Complications can occur during surgery such as anaphylactic shock. We report here the case of a patient who was admitted in our hospital for splenic hydatid cyst. She was 31 years old. She was admitted for a dull pain in the left hypochondrium. An abdominal examination objectified a patient with normal vital signs, she had a slight tenderness in the left hypochondria and epigastric regions. No hepatomegaly was found. Abdominal computed tomography revealed an isolated splenic cystic lesion measuring about 8, 2 cm in diameters and containing floating membranes. The patient was operated and a left subcostal incision. The Surgical exploration revealed a hydatid cyst occupying the middle region of splenic parenchyma, only a thin layer of splenic tissue was present in superior and inferior surface. At the end of the surgery the patient presented tachycardia, hypotension and extensive skin erythema. Conclusion: hemodynamic instability, should suggest the diagnosis of anaphylaxis in order to begin specific management, all preventive measures can be justified given of severity of anaphylaxis.

Keywords

• Anaphylactic shock,Hydatid cyst,Prevention,Surgery

Kaynakça

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