Mohamed Ben Mabrouk, Farhat Waad, Barka Malek, Mazhoud Jaafar,Harrabi Fethia, Souguir Ahlem, Kadri Khaled, Fethi Derbel, Ben Ali Ali
Objective Hydatidosis pancreatic site remains outstanding even in countries with endemic hydatid. The diagnosis can be difficult, confusing with other cystic lesions of the pancreas. The aim of this study was to describe clinical, radiological and therapeutic aspects of hydatid cysts of the pancreas. Methods This study was carried out in the Department of Digestive and General Surgery in Sahloul University Hospital, Sousse in Tunisia during the period 1993–2013. Ten patients were treated for hydatid cyst of the pancreas, four men and six women with an average age of 31 years. Results The clinical signs were variable according to size and location of the cyst within the pancreas and the degree of biliopancreatic involvement. The main symptoms were pain in left upper quadrant, jaundice, fever and epigastric and right upper quadrant pain. The preoperative diagnosis was established in six patients by ultrasonography and computed tomography. However, the diagnosis was established during laparotomy in two cases. The echinococcal immunological test was positive in only two cases. Surgical treatment included resection of the prominent lump (cystectomy) in five cases, total cystectomy in three cases and distal pancreatectomy with splenic preservation in one case and with splenectomy in one case. The postoperative period was uneventful in six cases. Acute postoperative pancreatitis occurred in one case. The patients were free of symptoms and were followed up for 24 months without any recurrence as revealed by abdominal ultrasonography and computed tomography scan. Conclusions Hydatid cysts in the pancreas are rare. Even if rare, the diagnosis should be considered in any pancreatic cystic mass in endemic countries like ours. Diagnosis is difficult when it is a unique and isolated location, may even pose therapeutic problems. The surgical treatment is to be considered whenever possible.
