Kyste hydatique du muscle psoas: à propos d’un cas

Abstract

Le muscle psoas est une localisation exceptionnelle du kyste hydatique. Le but de cette lettre est de rapporter l'observation d'un kyste hydatique localisé au niveau du muscle psoas gauche chez un patient âgé de 32 ans. L'échographie, la tomodensitométrie ainsi qu'une sérologie hydatique positive ont contribué au diagnostic préopératoire. Le patient a été opéré par incision para rectale gauche type Jalaguier. L'examen microscopique du culot de centrifugation du liquide hydatique a mis en évidence des scolex et de nombreux crochets confirmant ainsi le diagnostic. L'évolution était bonne sans récidive après le traitement chirurgical.

Psoas Muscle, An Exceptional Location for Cystic Echinococcosis: About A Case

“…It's generally a banal swelling, of slow evolution, long well supported, and therefore unknown [2]. Some cysts may be revealed by complications such as nerve compression, urinary, vascular, or haematogenic superinfection that can lead to sometimes severe sepsis [4,13]. For our patient, the revelation of this disease was made by a painful swelling occupying the right flank, and the right iliac fossa (FID) of the abdomen.…”

“…The scarcity of muscular location is due to several factors, including the difficulty of local implantation of the embryo, caused by continuous muscle contractions and the production of lactic acid hindering the nesting of the embryo [3,4,5], the efficacy of liver and pulmonary filters that oppose the easy migration of the hexacanthe embryo into the systemic circulation [6. 7], the alternating muscle contraction-relaxation does not allow uniform vascularization and exerts a compression preventing the parasite fixation on the muscle [6,8,9,10].…”

“…Biology is essentially hydatic serology. It's of great diagnostic value when it is positive [4]. Its main role lies in post-operative surveillance, looking for a possible recurrence, when it shows an ascent in antibody levels [3].…”

“…The qualitative (Immunoelectrophoresis, electrosyneresis) and quantitative methods (Indirect Haemagglutination, Immunofluorescence, ELISA) are difficult to interpret, however, the Western Blot and Immunoimprint are more sensitive and specific [5,13]. In order to improve the sensitivity/specificity ratio, most authors prefer to combine two serological techniques, one quantitative: indirect haeaglutination, immunofluorescence, ELISA and the other qualitative: immunoelectrophoresis, electrosyneresis [4,22]. In the case of our patient, ELISA is the technique that was used.…”