Percutaneous drainage and hydatid cyst alcoholization a pregnant patient

Abstract

Background: Hydatidosis is an endemic parasitosis, caused by Echinococcus, which usually affects the liver (50–70%) and the lung. The symptomatology is variable depending on the location and size of the cyst. The ultrasound detects 90–96% of the cysts. The absence of positive serology does not rule out the disease. The standard treatment is surgical and in recent decades new minimally invasive procedures such as percutaneous drainage and videolaparoscopy have emerged, with excellent Results. Methods: We present the case of a 16-year-old patient who was admitted with a liver hydatid cyst diagnosis + 1st trimester gestation, after receiving treatment with albendazole for 2 months. In the ultrasound, a cyst image of 12.4 x 9 mm in segment 6 of the liver is shown, rounded, with defined walls, heterogeneous, with septa, fine echoes and image that protrudes in the suggestive light of the daughter vesicle. A single gestation, topical, heartbeats + is observed, corresponding to 9 weeks. Percutaneous drainage of the cyst was performed with a 8.5 Fr multipurpose catheter, using the Seldinger technique. Results: At the placement of the catheter it drains 1000cc of dark liquid + 700cc in later days. 20cc of absolute alcohol was instilled on the 11th day of the drainage and 10cc on the 18th day. The control ultrasound showed a decrease of 3.5 cm in diameter after the 1st alcoholization, no longer a cystic cavity was observed after the 2nd, so who is discharged without a catheter. Percutaneous drainage with aspiration of the content and instillation of scolicide agents has proven to be a technique, with little invasiveness, with excellent results in patients in whom surgery is not possible or at high risk. Absolute alcohol is the sclerotherapy agent against the wall of the hydatid cyst. Conclusion: This patient has shown that percutaneous drainage is a feasible alternative to surgery, even in large cysts, and in patients with surgical contraindication, with low risk of complications.