Abstract
A 23-year old student presented with severe lumbago and numbness of lower extremities. Echinococciasis of the sacrum and perisacrum was confirmed by MR, US and laboratory findings. A multilocular hydatid cyst was located in the lumbo-sacral canal occupying both sides of sacral foramens. It protruded anteriorly to pelvis forming two large multilocular cysts behind urinary bladder and extended posteriorly into soft tissue of the back. The sacral “mother cyst” was too complicated to be treated surgically. Before PEIT, dorsal approaches were selected for percutaneous puncture and drainage of the whole cyst. Guided by real-time ultrasound, 18G needle was inserted to get through enlarged posterior-anterior sacral foramens into distal part of the pelvic cyst and destroy daughter cysts as many as possible. The patient tolerated well without untoward side effects finally recovered dramatically and started to work. Two-y MR follow-up studies showed good response to this conservative treatment. A 23-year old student presented with severe lumbago and numbness of lower extremities. Echinococciasis of the sacrum and perisacrum was confirmed by MR, US and laboratory findings. A multilocular hydatid cyst was located in the lumbo-sacral canal occupying both sides of sacral foramens. It protruded anteriorly to pelvis forming two large multilocular cysts behind urinary bladder and extended posteriorly into soft tissue of the back. The sacral “mother cyst” was too complicated to be treated surgically. Before PEIT, dorsal approaches were selected for percutaneous puncture and drainage of the whole cyst. Guided by real-time ultrasound, 18G needle was inserted to get through enlarged posterior-anterior sacral foramens into distal part of the pelvic cyst and destroy daughter cysts as many as possible. The patient tolerated well without untoward side effects finally recovered dramatically and started to work. Two-y MR follow-up studies showed good response to this conservative treatment.
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