Complication Of Hydatid Disease Research Articles

History of Diagnosis, Complications and Treatment Methods of Echinococcosis in Kyrgyzstan

A brief analysis of literature data is presented. The lack of a unified approach to assessing identified parasitic pathology and the increasing complexity of determining the frequency of complications determine the relevance of the topic under consideration. The leading method for diagnosing echinococcosis is ultrasound, and only some patients have difficulty determining the nature of the disease. For the purpose of differential diagnosis, ultrasound angiography is used, which includes a number of vascular visualization methods. As a result, the authors conclude that only the use of instrumental data makes it possible to timely determine the nature of the disease, localization, size and complication of echinococcosis.

Cutaneous fistulization: An extremely rare presentation of hydatid liver cyst in a child.

We report the case of a 10-year-old child who presented with a renitent lesion on the left abdominal wall. Clinical, radiological, and intraoperative findings concluded to a cutaneous fistulization of a hydatid cyst of the left lobe of the liver. The diagnosis was confirmed by histopathological examination. The child was successfully treated with acombination of medical and surgical management. Complicated hydatid disease should be considered in the differential diagnoses of patients presenting with cutaneous fistulization, particularly in regions where hydatid disease is endemic.

Abdominothoracic fistulas due to complicated echinococcosis: surgical treatment and outcome

Abdominothoracic fistulas due to complicated echinococcosis: surgical treatment and outcome

Coexistence of pulmonary hydatid cyst and tuberculosis in a child: a case report

BackgroundThe echinococcosis and tuberculosis of the lungs are both endemic in Algeria.The coexistence of echinococcosis and tuberculosis in the same lobe of the lung is exceptional.Case presentationA 10-year-old girl was admitted with a history of productive cough, fever, and chest pain.Chest examination revealed decreased air entry at left lower lobe. Chest X-ray demonstrated a round left lower lobe with an air fluid interface. Chest CT scan with intravenous contrast showed a lingual hydroaeric formation measuring 5×6 cm with a detached membrane image.A diagnosis of a complicated hydatid disease of the lung was made and the patient was subsequently started on oral albendazole before undergoing exploratory thoracotomy where partial cystectomy and the obliteration of the pericyst cavity. Histopathology was notable for echinococcosis membrane characteristics.After 2 months, the patient re-presented with complaints of cough, hemoptysis, and dyspnea.Radiographic images favored repermeabilization of bronchopleural fistulas.The management was the closing of the bronchial openings.Histological findings include image characteristic of the echinococcosis and tuberculosis.The patient continued on albendazole and an anti-tuberculosis regimen, with concurrent functional physiotherapy sessions.During the following 3-year follow-up, drastic clinical, radiographic, and functional improvement was noted.ConclusionConcurrent tuberculosis and echinococcosis infection should be taken into consideration when patients present with persistent bronchopleural fistula in endemic areas.A multidisciplinary approach of different medical teams facilitates diagnosis and rapid treatment.

Hydatid cyst: Introducing a new surgical approach towards hepato-pulmonary fistula, a case report.

Introduction and importanceHydatid disease, caused by the zoonotic parasite Echinococcus granulosus, presents as cysts most commonly in the liver and the lungs. A hepato-pleural fistula is considered one of its complications and surgery remains the mainstay of treatment. A simultaneous invasive thoracic and abdominal access is routinely needed which is accompanied by increased morbidity and mortality.Case presentationIn this case report, we present an innovative, less invasive, non-classical approach.Clinical discussionWe introduce a successful transabdominal transdiaphragmatic laparoscopic technique for the management of a hepato-pulmonary fistula secondary to hydatid disease of the liver.ConclusionCompared to the classical method, this new surgical approach towards hepato-pulmonary fistula paves the way for minimally invasive surgeries to manage complicated hydatid disease with a lower mortality and morbidity, faster recovery and shorter hospital stay. The work has been reported in line with the SCARE 2020 criteria.

Intrabiliary and abdominal rupture of hepatic hydatid cyst leading to biliary obstruction, cholangitis, pancreatitis, peritonitis and septicemia: a case report

BackgroundHydatid cysts are fluid-filled sacs containing immature forms of parastic tapeworms of the genus Echinococcus. The most prevalent and serious complication of hydatid disease is intrabiliary rupture, also known as cystobiliary fistulae. In this study, a sporadic case of biliary obstruction, cholangitis, and septicemia is described secondary to hydatid cyst rupture into the common bile duct and intraperitoneal cavity.Case presentationA 21-year-old Iranian man was admitted to the emergency ward with 5 days of serious sickness and a history of right upper quadrant abdominal pain, fatigue, fever, icterus, vomiting, and no appetite. In the physical examination, abdominal tenderness was detected in all four quadrants and in the scleral icterus. Abdominal ultrasound revealed intrahepatic and extrahepatic biliary duct dilation. Gallbladder wall thickening was normal but was very dilated, and large unilocular intact hepatic cysts were detected in segment IV and another one segment II which had detached laminated membranes and was a ruptured or complicated liver cyst.ConclusionIntrabiliary perforation of the liver hydatid cyst is an infrequent event but has severe consequences. Therefore, when patients complain of abdominal pain, fever, peritonitis, decreased appetite, and jaundice, a differential diagnosis of hydatid disease needs to be taken into consideration. Early diagnosis of complications and aggressive treatments, such as endoscopic retrograde cholangiopancreatography and surgery, are vital.

Liver hydatid cyst opened into portal vein

Background: Hydatid liver disease is endemic especially in Mediterranean countries. Portal vein rupture of hydatid cyst is not frequent. The aim of this case report is to report an exeptionnel complication of liver hydatid cyst and to expose problems of therapeutic management. Methods: We here present a case of liver hydatid cysts complicated by rupture into the portal vein. Diagnose was made by abdominal computed tomography. The patient had a conservative treatment. No surgical treatment was possible. Results: She developed cirrhosis of the liver and died from complications. Conclusion: Complications of hydatid disease, such as rupture into the portal vein, can be lethal. Its therapeutic management is still problematic.

Liver hydatid cyst opened into portal vein

Background: Hydatid liver disease is endemic especially in Mediterranean countries. Portal vein rupture of hydatid cyst is not frequent. The aim of this case report is to report an exeptionnel complication of liver hydatid cyst and to expose problems of therapeutic management. Methods: We here present a case of liver hydatid cysts complicated by rupture into the portal vein. Diagnose was made by abdominal computed tomography. The patient had a conservative treatment. No surgical treatment was possible. Results: She developed cirrhosis of the liver and died from complications. Conclusion: Complications of hydatid disease, such as rupture into the portal vein, can be lethal. Its therapeutic management is still problematic.

Single-center experience in the surgical treatment of combined lung Echinococcosis.

Objectives:To compare results of surgical treatment and complications of patients with unilateral or bilateral thoracic and combined pulmonary echinococcosis.Methods:This cross-sectional analysis of a prospective study was conducted in the Department of Thoracic and Pediatric Surgery, Scientific Center of Surgery, Almaty, Kazakhstan among 598 patients with pulmonary echinococcosis, who had surgical treatment with various surgical methods, depending on the prevalence of echinococcosis, as follows: right lung in 357 (59.5%) patients, left lung in 243 (40.5%) patients, bilateral in 95 (15.8%) patients, and complicated echinococcosis in 317 (52.8%) patients. Length of stay per hospital stay has been decreased (p<0.0001) by video-thoracoscopic echinococcectomy with the high-energy laser (HEL) treatment of cyst, than after echinococcectomy by cyst treatment with povidone-iodine. Treatment with formalin presented the most longest hospital stay (p<0.0001)Results:Comparative analysis of patients with uncomplicated and complicated pulmonary echinococcosis showed a high frequency of postoperative complications associated with complicated echinococcosis (OR = 2.2, p<0.0001).Conclusion:Despite the success of surgical treatment of pulmonary echinococcosis, issues of intraoperative dissemination and safety remain, and treatment success rates can be improved. These factors require further prospective multicenter studies.

Broncho-Biliary Fistula Due to Hydatid Disease: Case Report

A Broncho Biliary Fistula (BBF) is a rare complication of echinococcosis. This occurs from rupture of a hydatid cyst located at the upper surface of the liver into the bronchial tree. Fistulisation, results in biliopytsis, which is expectoration of bile-tinged greenish-yellow sputum, a pathognomonic feature of BBF. Bilopytsis may also occur in other conditions such as hepatectomies, liver abscesses or trauma. Surgical fistula closure is the definitive management of these patients, however downstream biliary obstruction should be ruled out first. Almost all cases can be approached through a right postero-lateral thoracotomy followed by phrenotomy. However, if there are multiple cysts in the liver, a thoraco-abdominal incision may be necessary.

СОВЕРШЕНСТВОВАНИЕ ДИАГНОСТИКИ И ЛЕЧЕНИЯ РАЗЛИЧНЫХ МОРФОЛОГИЧЕСКИХ ФОРМ ЭХИНОКОККОЗА ПЕЧЕНИ

Summary . The Objective of the work was to find ways to optimize the diagnostic and therapeutic measures in patients with hepatic echinococcosis in view of the morphological forms of parasitic cysts. The study is based on a study of the results of the application of different options for surgical interventions in the treatment of 305 patients with liver echinococcosis. All patients in the last 10 years (2005–2015) have been treated in the II Clinic of Samarkand State Medical Institute. Postoperative complications were observed in 35 (11.5 %) patients, postoperative mortality was noted in 1 (0.3 %) cases. Echinococcosis Relapse occurred in 17 of 236 patients observed in the long term (77.4 %). The results of surgical treatment of hydatid cysts of the liver are largely dependent on a differentiated approach to the choice of an adequate method of surgical treatment, taking into account morphological form cyst and the principles aparazitarnosti and anti-parasitic. In the late period of echinococcosis recurrence was observed in 2.9 % of patients operated on for complicated echinococcosis, and in 4.2 % of patients who refused chemotherapy postoperatively. Key words : еchinococcosis of the liver, morphological forms, diagnosis, treatment.

Giant cardiac hydatid cyst: case presentation with radiologic survey and review of literature

Hydatid disease is mostly localised to liver and lungs. Cardiac involvement is a rare but potentially very serious complication of echinococcosis, constituting only 0.5–2% of all cases of hydatidosis. Cardiac hydatid cyst is a diagnostic and therapeutic challenge on account of highly variable clinical presentations and non-specifi c symptoms and often numerous unpredictable complications. We present a case report of 20-year-old man who was admitted to our hospital with chief complaint of palpitations and shortness of breath. Using baseline investigations like ECG, transthoracic echocardiography, ultrasonography, non-contrast computed tomography and magnetic resonance imaging, a giant multiloculated cystic lesion (58.4 mm × 43.3 mm) was diagnosed in the apex of left ventricle. Serologic tests (hydatid cyst antibody) confi rmed Echinococcus infection. Thoracic computed tomography with intravenous contrast was not performed because patient reported history of allergy to contrast. This case report is unusual as it is concerned with the description of a rare disease entity (large cardiac hydatid cyst). Its radiological appearances are discussed for early diagnosis and better understanding of the disease, together with a review of the literature.Journal of Kathmandu Medical CollegeVol. 3, No. 4, Oct.-Dec., 2014Page:

PO-0906 Intraperitoneal Rupture Of Hepatic Hydatid Cyst Following Blunt Abdominal Trauma In A 7-year-old Boy

<h3>Background</h3> Although Hydatid liver disease may be asymptomatic, one complication of Hydatid disease is perforation of the cyst into the peritoneal cavity after trauma. We present herein a case presented after trauma and had a diagnosis of Hydatid cyst rupture into the peritoneum previously asymptomatic boy. <h3>Case</h3> A 7-year-old boy presented with mild abdominal pain for 6 h. His parents told that his abdominal pain was suddenly commenced after falling down from swing when playing at the playground. They also complained of itching on the whole body starting soon after the trauma. His blood pressure was 90/60 mmHg, heart rate 118/min, and temperature 37.0°C. On the physical examination, urticaria was seen over the thigh and trunk, abdominal examination revealed generalised tenderness. Ultrasonography and computed tomography showed multiple cystic lesions in the liver and one of them had hypoechoic contents and floating echogenic membranesand also free fluid were seen in the pelvis. Intravenous fluids were started followed Hydrocortisone and antihistamine administered along with antibiotic prophylaxis. The patient underwent surgery, 3 cysts at different localization and also a ruptured cyst 4 cm in diameter at the segment 1 were seen. The germinative membranes and the daughter vesicles were removed and abdomen was irrigated with hypertonic saline (3% NaCl). Postoperative albendazole therapy was given for two months. <h3>Conclusion</h3> Rupture of Hydatid cyst should be considered in the differential diagnosis at the presentation of acute abdominal findings with urticaria after abdominal blunt trauma. US and CT are effective in diagnosing of this rare condition.

The Role of Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Management of Intra-Biliary Rupture of Liver Hydatid Cysts (IBRH): Follow-Up of 12 Cases

Background: Intra-biliary rupture of hydatid cyst [IBRH] is not a rare complication of hydatid disease of the liver and surgery until recently is the only definitive treatment. With the introduction of ERCP preoperatively or postoperatively there was a great reduction in the operative complications. There were reports in which the ERCP was the sole treatment of this condition. Objective: To evaluate role of ERCP in the management of cases of IBRH. Design: A retrospective study of 7 cases of IBRH and prospective study of 5 cases of IBRH managed by ERCP. Setting: The ERCP Unit of Kurditan Center for Gastroenterology & Hepatology, Asulaimaneyah-Iraqi, Kurdistan, Iraq. Main Outcome Measurements: Improvement in the symptoms, obstructive liver functions pattern and ultrasonic findings in these patients following ERCP management. Methods: This is a study of 12 cases of IBRH managed by ERCP in the Kurdistan Center of Gastroenterology (KCGE) in Asulaimaneyah-Iraq, from 2007-2010. Seven cases of these were studied retrospectively from the available information on the center computers and on follow-up of these patients, while the other five patients were studied prospectively during the study period. We collected the available information: laboratory investigations, trans-abdominal ultrasonography (TAUS), computed tomography (CT) or magnetic resonance images (when available), before and after ERCP. We depended on the liver functions, trans-abdominal ultrasound and the clinical presentation before and after the ERCP; some patients were contacted via mobile phone for follow-up. Results: Cases were more males than females (58% vs 42%); most were from the ages between 30 - 50 years. The clinical presentation was fever, jaundice, itching and right hypochondrial pain in most patients. The liver function tests were obstructive pattern with elevated direct bilirubin and alkhaline phosphates in most patients. The trans-abdominal ultrasound revealed dilated common bile duct and single liver cyst in most patients and 2 or 3 cysts in others. The ERCP management led to improvement in clinical, laboratory and ultrasonic findings in 6 patients and in these 6 patients ERCP was the only procedure needed and proved by follow-up of these patients for 1 year in 4 patients and 2 years in the other 2 patients, especially in those with hydatid mebranes seen at ERCP and those with cholangiographic evidence of communication with the cyst; surgery was needed in 5 cases and one patient died from septic shock. Conclusions: ERCP is an important management strategy for patients with IBRH, which can lead to clinical, laboratory and ultrasonographic improvements, and can be the only required procedure in more than 50% of cases especially in those with hydatid mebranes seen at ERCP and those with cholangiographic evidence of communication with the cyst.

Acute intraperitoneal rupture of hydatid cysts: a surgical experience with 14 cases

IntroductionHydatidosis is endemic in the Mediterranean region including morrocco, the Middle and Far East, Australia, New Zealand, and South America—all areas where animal husbandry is common. Rupture into the abdominal cavity is a rare but serious complication of hydatid disease. The cysts may be ruptured after a trauma, or spontaneously as a result of increased intracystic pressure. Rupture of the hydatid cyst requires emergency surgical intervention.MethodsFourteen patients received surgical treatment for intraperitoneal rupture of the cysts over a period of 5 years. Age, gender, time to surgery from the onset of the symptoms, laboratory findings, diagnostic procedures, surgical treatment modalities, in-hospital stay, morbidity, mortality and recurrence were evaluated retrospectively.ResultsEight of the patients were men and six were women. All of the patients had signs of peritoneal irritation. One patient (7,14%) had a history of blunt abdominal trauma. Ultrasonography scans revealed intra-abdominal fluid in all cases, intraperitoneal multiple cysts in 11 cases and heterogeneous cavity or cystic structures in the liver in 12 cases. Computed tomography showed multiple cystic lesions in the liver and peritoneum with intra-abdominal free fluid. The ruptured cysts were located in the right lobe of the liver in seven patients, in the left lobe in six patients and in both lobes in one patients. Procedures to fill the cystic cavities were applied after removal of the intraperitoneal fluid. Partial pericystectomy and drainage was the most frequent surgical procedure. No patients died in the early postoperative period. A total of seven morbidities developed in six patients (35.3%). Median hospital stay was 08 days and median follow-up was 12 months. Intra-abdominal recurrence occurred in one case (7.7%).ConclusionsRupture of hydatid cysts into the peritoneal cavity, although rare, presents a challenge for surgeons. This pathology should be included in the differential diagnosis of acute abdomen in endemic areas. The operative procedures, either radical or conservative, should be based on the patient’s condition, the regional characteristics, and the surgeon’s experience. The morbidity and mortality rates of surgical interventions for ruptured hydatid cysts are higher than the rates for elective uncomplicated cases.

Hydatid cyst of liver complicated with Budd-Chiari syndrome and portal vein thrombosis

Hydatid cyst of liver complicated with Budd-Chiari syndrome and portal vein thrombosis

Capitonnage Results in Low Postoperative Morbidity in the Surgical Treatment of Pulmonary Echinococcosis

The main surgical techniques in the treatment of pulmonary echinococcosis are cystotomy alone, cystotomy and capitonnage, enucleation, and pericystectomy. Controversy persists regarding the selection of surgical technique. We reviewed our experience to identify the impact of capitonnage on outcomes. A single-institution retrospective analysis was made of the 308 consecutive patients with thoracic hydatid disease treated surgically during 17 years. The most common presenting symptoms were cough and chest pain. At presentation, 69 patients (22.4%) had complicated hydatid disease, cyst rupture into bronchus in 62 and into pleural cavity in 7. Bilateral involvement occurred in 37 patients (12.0%), simultaneous hepatic cysts in 36 (11.6%), and intrathoracic extrapulmonary involvement in 14 (4.5%). Surgery consisted of cystotomy with capitonnage in 271 patients (92.2%), cystotomy and closure of bronchial openings in 20 (6.8%), and lobectomy in 3 (1.0%). Hospital mortality was zero; postoperative complications developed in 21 patients (6.8%). Cystotomy with capitonnage has a low complication rate. Pulmonary resection is best limited to patients with parenchymal destruction secondary to infection.

Liver Cyst Hydatid Fistulated Into Duodenum

Hydatid cyst of liver is a disease usually seen in endemic regions. While it is very small at the beginning, cyst diameter increases approximately 1-3 cm per year. Among known complications of hydatid disease, pressure to the adjacent organs due to the cyst growth, perforation into peritoneal cavity or bile truct are most noteable. However, its fistulization into gastrointestinal tract is very rare. A 80-year-old male patient presented with the complaints of abdominal pain, fever and deterioration in general physical condition. It was determined that the patient was diagnosed with hydatid cyst of liver about 15 years ago but refused treatment. Imaging revealed a 20x15 cm multiseptal cystic lesion filled with air in the right lobe of liver. Patient was admitted to OR and exploration revealed that cyst had fistulized into the duodenum. The fistulization of liver hydatid cyst into the duodenum is very rare. We believe that the size of cyst and the delay in treatment caused the cystoduodenal fistula.

A giant hydatid cyst of the liver

Hydatid disease remains a global health problem, and its cure is still controversial. Despite efforts of the World Health Organization, this disease continues to be endemic in many countries while immigration is responsible for cases in countries previously unfamiliar with the disease. In this article, we present the case of a patient with a giant hydatid cyst of the liver and its management. Being a slowly progressive disease, it is generally discovered incidentally — unless the patient presents, as in our case, with a complicated hydatid disease. Modern diagnostic modalities enable disease classification, thereby facilitating a therapeutic plan. Surgery remains the mainstay of treatment and should be individualized according to the patient’s overall health status and the predicted perioperative morbidities.

Hydatid Cyst Causing Femoral Artery Embolism arid Ischemic Syndrome of a Lower Limb

An intracardiac hydatid cyst is a rare but potentially very serious complication of hydatid disease as the rupture of the cyst may lead to embolisation of the femoral artery. We report the case of a 29-year-old man who was admitted with the diagnosis of arterial occlusion of the left leg. During surgery, a large hydatid cyst causing femoral artery occlusion was found and excised. This case emphasizes that, in endemic countries, primary vascular echinococcosis should be considered in the differential diagnosis of arterial occlusion.