Traumatic rupture of an isolated splenic hydatid cyst: a rare and challenging surgical emergency

Isolated splenic hydatidosis is a rare manifestation of Echinococcus granulosus infection, accounting for ~0.5%-4% of reported cases. Although often asymptomatic, cyst rupture is an uncommon but severe complication that may result in life-threatening systemic reactions, frequently precipitated by trauma. A 65-year-old Saudi male with type 2 diabetes mellitus and hypertension presented with acute epigastric pain, nausea, vomiting, and low-grade fever one week after minor trauma. He was hypotensive with a tender, non-peritonitic abdomen, and elevated inflammatory markers. Contrast-enhanced computed tomography demonstrated a large ruptured splenic hydatid cyst with intraperitoneal fluid. Emergency laparotomy with total splenectomy was performed, and histopathology confirmed the diagnosis. Recovery was uneventful, and albendazole therapy was initiated. Minor trauma may precipitate rupture of an unrecognized splenic hydatid cyst, and early imaging with prompt surgical management is critical to prevent life-threatening complications, particularly in endemic regions.