Isolated omental hydatid cyst--a case report

Isolated omental hydatid cyst is a very rare clinical entity. Here, such a case has been presented where abdominal cystic mass came out as isolated hydatid cyst in the greater omentum.     

肝包虫囊肿钙化并多发结石4例

目的分析钙化性肝包虫囊肿并发结石的原因、诊断及治疗。方法依据病史,体征及B超、CT、包虫皮试作出诊断,4例病人均经手术治疗。结果术中证实为钙化单发性包虫囊肿与肝内胆道瘘,其中1例并腹腔破裂,经手术治愈。结论包虫囊肿结石甚为少见,它的形成与胆汁漏入其内及感染有关;有结石的包虫外囊壁均有钙化,囊壁钙化与结石形成之间的关系尚不清楚;包虫囊肿内结石均为多发性小结石。充满囊腔。本病的治疗与破裂肝包虫病的治疗相同。     

48例肝包虫病诊治体会

目的探讨48例肝包虫患者的诊治体会。方法对1999-01~2005-06间收治的48例肝包虫病例资料进行回顾性分析。方法:外囊缝团术(8例),内囊摘除外囊缝合引流术(30例),网膜填塞术(10例)等处理方法。结果术后合并胆漏29例,均自愈。目前未见复发的病例,48例患者均获满意疗效。结论肝包虫病治疗以外科手术治疗为主,穿刺需谨慎,术中根据不同的情况采取不同的、合理的措施,可以获得满意的治疗效果。     

A primary spinal hydatid cyst

Hydatid disease occurs in humans as a result of faeco-oral contamination. Spinal hydatid cyst is a rare entity and a serious form of hydatid disease affecting less than 1% of the total cases of hydatid disease. Neural compression is common in vertebral hydatidosis where prognosis is always considered as very poor. Difficulty in management due to recurrence of this rare entity makes it a challenging disease to eradicate entirely. Efficacy of use of anthelminthic even after complete surgical removal is yet to be established. We are reporting diagnosis and management of a case of primary extradural and paraspinal hydatid cyst (HC) in an otherwise healthy patient who did not show any other evidence of systemic hydatid disease. The diagnosis was recognized preoperatively by magnetic resonance imaging (MRI) and confirmed postoperatively by histopathology. Surgical removal of the cysts/lesions was followed by anti-helminthic medication and recovery was satisfactory until the patient had recurrence after one year. The patient underwent surgery for the second time and was given anti-helminthic again for a longer period and was recurrence free for the next one year.     

Primary orbital hydatid cyst: computed tomography and magnetic resonance imaging findings

Orbital hydatid cyst is a rare form of hydatidosis, comprising less than 1% of all hydatid cysts reported. The first choice of treatment for orbital hydatid cyst is surgery. Preoperative diagnosis is important, so as to avoid rupture of the cyst and prevent the spread of the parasitic disease. Herein, we present the computed tomography and magnetic resonance imaging findings of a case of primary orbital hydatid cyst.     

Splenic recurrence of liver hydatid cyst and spleen preserving therapy

Hydatid cyst disease remains a considerable public health problem, especially in pastoral and farming regions. Although the spleen is the third most commonly affected organ after the liver and lungs, splenic hydatid cyst is an uncommon entity even in areas that are endemic for echinococcosis. The recurrence rate after surgical therapy of the liver hydatid cyst is reported as 6.8-22.3 percent. Recurrences most frequently occur in the liver. Extrahepatic recurrences occur in the lung or peritoneum and the serosa of the abdominal organs. Splenic recurrence of liver hydatid cyst has not previously been reported. The most common surgical therapy is splenectomy, and the other option is spleen preserving surgery. We report the first case of recurrent splenic hydatid cyst in the spleen and liver synchronously after surgical therapy for liver hydatid disease. The patient was treated with liver resection and spleen preserving surgery.     

肝包虫病的螺旋CT诊断

目的:提高对肝包虫病的螺旋CT表现的认识。方法:回顾分析经本院螺旋CT检查及手术病理证实的21例肝包虫病螺旋CT表现。结果:囊型包虫病18例,其中单纯囊肿8例,表现为圆形水样密度区。多子囊型10例,表现为在一个大囊内可见数量不等的更低密度小圆形低密度区,边界清晰。钙化14例,为囊壁壳状钙化囊内不定形条片状钙化。包虫囊肿合并感染4例,表现为囊壁增厚,强化明显。泡型包虫病3例,呈不规则及不均匀密度影,所有病灶内均有钙化灶,其中1例病灶边缘有晕样改变区。所有病例CT均诊断正确。结论:螺旋CT可以很好显示肝包虫病病灶,对肝包虫病具有较高的诊断率。     

Primary ovarian hydatid disease in the Kingdom of Saudi Arabia

Human hydatid disease is caused by Echinococcus granulosus. Its distribution is world wide and it affects mainly the liver, but other organs could be involved. Primary involvement of pelvic organs is very rare. This is a case report of primary ovarian hydatid disease in a postmenopausal woman, diagnosed postoperatively. Surgical excision was adequate. Ultrasonography, particularly high frequency trans-vaginal, computed tomography scan and, more recently, magnetic resonance imaging are more frequently used in the diagnosis of Echinococcus cyst. They appear more reliable than many of the old tests of varying sensitivities. Whereas, there are anecdotal reports of obstetric and gynecological manifestations of echinococcosis from some Middle Eastern and North African countries, this is the first of such report from the Kingdom of Saudi Arabia. It is unclear why there is a lack of information about this condition among Saudi women, even though socio-cultural attitude to female involvement in sheep farming and animal husbandry is similar to that in other Arabic and Islamic countries. We endorse the recommendation that every gynecologist, radiologist and histopathologist should maintain a high index of suspicion for hydatid cyst, whenever a septate cystic pelvic mass is found.     

Diagnosis and management of hepatic hydatidosis complicated with biliary fistula.

A total of 1,204 patients with liver hydatidosis were treated by operations in our hospital from 1953 to 1990. Of these 74 had biliary fistulae. Growth of echinococcus cyst causes displacement, distortion and stenosis of the hepatic ductules with impaired bile drainage. Biliary effusion may occur between the endo- and ecto-cyst walls. Long term compression renders the hepatic ductule atrophic, and liable to rupture, forming a hydatid cyst-biliary fistula. The hydatid cyst can rupture into the biliary tract, and cyst fluid escapes into the biliary tract with daughter cysts discharged into the common bile duct, causing biliary colic, obstructive jaundice and possibly liver abscess. For acute obstructive and suppurative cholangitis, drainage of purulent bile and daughter cysts and management of the infected hydatid cyst are indicated. After removal of the echinococcus cyst, the fistulous opening on the hepatic duct must be sutured, but a small biliary fistula may be left alone. According to the thickness of the ectocyst wall, size of the cavity, severity of the infection, and degree of bile leakage, one of the following operative procedures for obliteration of the residual cavity can be selected: (1) closure by inversion suture of ectocyst; (2) omental or muscle flap obliteration; (3) closed catheter drainage.

     

Giant abdominal hydatid cyst masquerading as ovarian malignancy

Hydatid disease, caused by Echinococcus granulosus, is a common parasitic infection of the liver. Disseminated intra-abdominal hydatid disease may occur with the rupture of the hydatid cyst into the peritoneal cavity, producing secondary echinococcosis. Occasionally, the cyst may not rupture, and instead, enlarge, thus mimicking gross ascites or huge ovarian tumours. We present a 30-year-old woman with a giant intra-abdominal hydatid cyst communicating with the liver, and discuss the management of her case.     

Echinococcosis (Hydatid Disease): Review and Report of a Case of Secondary Echinococcosis

Echinococcosis is a disease caused by the larval form of Echinococcus granulosus. The adult worm lives parasitically in the intestine of the definitive host, the dog, wolf and other wild carnivores. The ova, which are passed in the feces, are ingested by grazing animals. The intestinal juices free the ovum from its cuticle and, having entered a capillary, it is carried by the blood stream to the liver or lung, where it develops into a hydatid cyst. Man becomes infected by ingesting contaminated vegetables or drinking contaminated water.

In a mature hydatid cyst there may be thousands of scolices and each one of these, if released from the hydatid cyst, may form a new cyst if it is planted in a suitable environment. Hydatid cysts are most commonly found in the liver and the lung, but may occur in other organs.

A hepatic cyst may rupture into the peritoneal cavity and produce a hydatidoperitoneum. A pulmonary cyst frequently ruptures into a bronchus and is thus evacuated.

The disease is of world-wide distribution. In Canada most of the cases of this disease have occurred among Indians and Eskimos. It is now known that a sylvatic cycle has been established in North America and that it serves as a source of infection of the dog and man.

The patient reported herein had spontaneous rupture of a hepatic hydatid cyst, with subsequent development of secondary peritoneal echinococcosis. Repeated laparotomies had to be performed to relieve pressure on or obstruction of various organs. The patient made an uneventful recovery and is again usefully employed. No effective medical treatment for this disease is available.

     

A rare primary location of echinococcal disease: report of a case

A case of primary hydatid disease, a rare location, is presented. The patient was a 20 year old female who presented with complaining of painful mass in the right hypochondrium 2 months before presantation. This cyst was strongly adherent to the two layers of m.rectus abdominis fascias. It was completely removed. No other site of hydatid disease was found and the patient remained well postoperatively.     

The Effect of Peep-ventilation on Cardiac Function in Closed Chest Pigs

A case of primary hydatid disease, a rare location, is presented. The patient was a 20 year old female who presented with complaining of painful mass in the right hypochondrium 2 months before presantation. This cyst was strongly adherent to the two layers of m.rectus abdominis fascias. It was completely removed. No other site of hydatid disease was found and the patient remained well postoperatively.     

Laparoscopic excision of splenic hydatid cyst

Hydatid disease of the spleen is a rare condition. The standard treatment is open total or partial splenectomy. Recently hand assisted laparoscopic total splenectomy for splenic hydatid cyst has been reported. A case is described of splenic hydatid cyst in a 45 year old man that was excised laparoscopically; the related literature is reviewed.     

Spontaneous intraperitoneal expulsion of an unruptured hydatid cyst

We report a 43-year-old man with a 20 x 20 cm hydatid cyst, spontaneously extruded out from the left lobe of the liver. This complication of hydatid cyst has not been recorded earlier, and makes the case unique in itself and worth reporting. The patient presented with a rare complication of biliary peritonitis of hydatid disease.     

眼眶包虫囊肿的CT诊断(附4例报告)

作者分析了4例经手术、病理证实的眼眶包虫囊肿的CT表现。显示为眶内圆形或椭圆形,边界清楚的囊性病变。其CT值近似水的密度。增强扫描囊壁不增强或仅轻微增强。本病的CT表现颇具特征性,是诊断艰眶包虫囊肿安全可靠的理想检查方法。此外还对某些少见病例的鉴别诊断进行了讨论。     

不同分型的囊型肝包虫囊内环境的研究

目的：探讨不同分型囊型肝包虫PH值、囊内压、渗透压及内囊生发层的变化是否存在一定的规律性。方法：应用精密PH值测定仪检测肝包虫囊肿囊液PH值的变化；采用穿刺测压法检测肝包虫囊肿囊内压力的变化；应用渗透压测定仪检测肝包虫囊肿囊液渗透压的变化；采用苏木素-伊红染色，观察肝包虫囊肿存活情况及内囊生发层病理组织学改变。结果：不同分型囊型肝包虫，其囊液的PH值、囊内压力、囊液的渗透压、内囊生发层的变化有显著差异（〈0.01）。结论：不同分型的囊型肝包虫随着其活性的变化，囊内环境亦呈有规律的变化。     

Hydatid disease: an unusual breast lump

Hydatid disease of the breast is rare, but it should be included under differential diagnosis of a breast lump especially in endemic areas of this disease. Fine needle aspiration cytology can provide a safe pre-operative diagnosis, although mammogram, ultrasonography of breast, magnetic resonance imaging and serological tests like Casoni's test can also be done. Complete excision of the cyst without spillage can be a curative procedure for primary hydatid cyst of the breast. It is important to explore other common sites like liver and lung by means of ultrasonography and chest x-ray and treat accordingly. Here in this report, a lady of 27 years old presented with a painless lump of the left breast. Fine needle aspiration cytology was inconclusive. Lumpectomy was done. Histopathological examination confirmed it to be a case of hydatid disease involving the left breast.     

肝包虫术后残腔并发症的防治(附173例报告)

目的讨论肝包虫内囊摘除术后残腔并发症的防治方法。方法回顾分析我院1960年1月至2004年1月肝包虫内囊摘除术后外囊残腔并发症173例,占同期肝包虫手术的17．49％(173／989)。其中残腔感染104例(60．12％),残腔出血2例(1．16％),残腔胆汁漏51例(29．48％),钙化残腔不闭合13例(7．51％),残腔消化道瘘3例(1．73％)。87例(50．29％)经再次手术治疗。结果术后腹腔感染7例(8．05％),伤口感染11例(12．64％),肺部感染4例(4．6％),死亡3例(1．73％)。本组治愈率为98．27％。结论肝包虫内囊摘除术后残腔并发症发生率较高,其中以残腔感染及胆汁漏最为常见,部分病例治疗甚为困难,严重影响病人的生活质量甚至生命。包虫囊肿完整切除可有效地预防术后残腔并发症。近来有人提出包虫外囊与肝组织之间有一层疏松的结缔组织称为“外科膜”,该膜有利于包虫囊肿完整切除。作者认为包虫囊肿完整切除应根据病人的全身及局部情况和术者的经验而定,不可盲目从事。     

磁共振水成像技术在包虫病诊断中的应用

目的：探讨磁共振水成像（MRH）技术在包虫病诊断中的作用，以利于临床手术方案的制定和预后的评估。方法：69例包虫病患者中47例为细粒棘球蚴病，22例为泡状棘球蚴病，69例均行常规MR和MRH检查。结果：47例细粒棘球蚴病中31例为单囊，MRH显示更清晰，16例为多子囊，12例多子囊的110个子囊中，MR普通检查检出率为56．36％，MR水成像检出率为98．18％。MR水成像检出的病灶明显多于MR普通检查检出的病灶。16例泡状棘球蚴病中MR普通检查共发现68个病灶，磁共振水成像技术共发现123个病灶。结论：MRH结合常规磁共振检查可显示包虫病自身的精细结构，并可获得更多包虫病与临近结构关系的信息，二者结合在包虫病的诊断方面具有许多优势，尤其是对合并并发症的复杂类型的包虫病的诊断。