Diagnosis Of Hepatic Echinococcosis Research Articles

Hepatic echinococcosis: difficulties in diagnosis at the early stages of progression and with complications (literature review)

To demonstrate the possible difficulties in the diagnosis of hepatic echinococcosis, that a specialist in ultrasound diagnostics and a radiologist may encounter in everyday practice, russian and foreign literature as well as our own experience have been reviewed. With high accuracy and specificity of ultrasonography in the differential diagnosis of echinococcal cysts, incorrect interpretation is possible in the presence of mural hemorrhages and (or) hemorrhagic clots in a nonparasitic cyst, which aren’t also visible in ultrasonography and can imitate elements of the chitinous membrane. The degree of prevalence of the process, the exclusion of damage to the lungs and other organs of the abdominal cavity are important. In such cases CT scan is the most convenient and accurate diagnostic method due to its high spatial and temporal resolution, standardization and availability. In the most difficult cases the capabilities of MRI are used in the comparison of diffusion-weighted images and apparent diffusion coefficient, which also makes it possible to diagnose cystic neoplasms. Ultrasonography is a diagnostic technology that is still the most commonly used to differentiate cavity structures; however, all dubious clinical observations should be further examined by using CT or MRI.

Magnetic Resonance Cholangiopancreatography in the Diagnosis of Haemobilia

Haemobilia is a rare cause of unrecognized gastrointestinal bleeding and is hard to diagnose. Through the present case report we aim to corroborate magnetic resonance relevance in the evaluation of biliary system and bile features, investigating on its role in patients with acute biliary diseases. We report a case of a Caucasian 48-year-old man who was admitted due to abdominal pain and fever. After an ultrasonography exam we detected multiple cysts in the hepatic left lobe: imaging features, laboratory findings, and patient past work experience (woodcutter) suggested a diagnosis of hepatic Echinococcosis. Once surgery decision was taken, patient underwent an intervention of cystopericystectomy. On the 8th postoperative day, the procedure was complicated by black stool, jaundice, and severe anaemia. Acomputed tomography revealed an inhomogeneous collection with some air bubbles in the area of previous surgical intervention, but it was not able to solve the diagnosis question. At this stage a magnetic resonance study was mandatory. On T2-weighted images we observed an expanse gallbladder with hypointense intraluminal material and a considerable intrahepatic biliary system dilatation due to bloody material. On the basis of these examination results, we supposed haemobilia arising from previous surgical intervention. A therapeutic endoscopic retrograde cholangiopancreatography procedure led to decompression of biliary system through a major papilla sphincterotomy with spillage of bile mixed with blood clots.