The role of ultrasonography in the diagnosis of small echinococcal cyst of the spleen to children – considerations related to a case

Introduction: Spleen is the third most common location of hydatid disease after liver and lung. Symptom presentation is varied and nonspecific.

Aim: We porpose to present the role of ultrasonography in tracking small cystic echinococcosis of the spleen to children.

Matherial and method: We present a ten years old boy admitted in our hospital with the souspicion of urinal infection, presenting abdominal colicative pain with fever and vomiting. Paraclinical method marks out: uroculture with E coli., the abdominal ultrasonography markes out spleenomegaly and in the middle one aproximately a 9mm fluid-filled mass with a well-defined outer wall and 1/2 internal septations. In differential diagnosis were taliking into consideration: true cyst, congenitall, epithelial lining, pseudocyst, with or without calcification in wall (especially with haematoma or echinococcus), assocated with trauma in childhood, abcess, echinococcal cyst.

Results: The ELISA test for echinococcosis beeing positive (18 UI/mm) it was settled the echinococcal cyst diagnosis, produced probably by the Echinococcus granulosus. The presence of other localisations and complications by dissemination were excluded. The Mebendazol treatment was established. After four mounths, the child came for ultrasonography evaluation, the cyst rested 9mm, after 1year 4 month the result of the analysis beeing a growth of the cyst to 3.8cm. The case was sent to revaluation.

Conclusion: The ultrasonography is the imaging method, that can discover in real time echinococcal cystic images, from very small dimensions and is not necessary for another imagine method. US is useful in longitudinal studies, such as monitoring the response of cysts to treatment and recording cyst growth rate The etilogy of cyst is confirmed by complementary methods

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