Giant Hydatid Cyst Research Articles

A benign rare intraabdominal lesion: Primary giant mesenteric hydatid cyst

Hydatid disease, mostly caused by Echinococcus granulosus, is a common parasitic infestation of the liver. In this type of infectious disease, humans are an intermediate host. Although most common sites are liver (70%) and lungs (25%), this parasitic tapeworm can be seen at any region of the body. Intraperitoneal cysts are usually secondary to the rupture of primary cysts, but primary hydatid cysts of the mesentery are very rare (%2). Herein, we aimed to report a giant primary hydatid cyst in a male patient, treated surgically without any complications.

Giant pulmonary hydatid cyst in children

BackgroundLungs are the second most common site for hydatid disease after the liver. Giant hydatid cyst (GHC) of the lung is a special clinical entity in children and is related to higher lung tissue elasticity. AimTo compare clinical and imaging features, types of surgical interventions, and postoperative complications in pulmonary GHC and non-giant pulmonary hydatid cysts (NGHC) in children. MethodsA retrospective study was undertaken. The data analyzed were taken from medical records of children with pulmonary hydatid cyst (PHC) hospitalized in a pulmonary department in Tunisia between January 2004 and February 2019. Cysts were divided according to their size into GHC ( ≥10cm) and NGHC (<10cm). ResultsIn the study period, 108 PHC were recorded in 84 children. GHC accounted for 21 (19.4%) and NGHC for 87 (80.6%). The median of age of the children was 11 years (IQR 1–9, IQR 3–14) and the mean age was 11.6 years (10.5 in GHC vs. 11.4 years in NGHC). Hemoptysis was found in 25% of the GHC group vs. 48.4% of the NGHC group (P=0.27). Cysts were multiple in 23.8% of cases and predominated in the right in 64.3% of cases and in the inferior lobes in 71.4% of the cases. GHCs were less frequently complicated (60% vs. 78.1% in NGHC, P≤0.11), although not significantly. Parenchymal resection was realized in 50% of GHC vs. 18.8% of NGHC (P=0.006). No significant difference was found in postoperative complications between the two groups and there was no recurrence in either group. ConclusionGHC is a special clinical entity in children. It requires major surgery with parenchymal resection, and therefore early diagnostic and therapeutic management is warranted.

Roux En Y drainage of a large hepatic hydatid cyst as treatment for recalcitrant bile leak: a case report

BackgroundHydatid disease is relatively uncommon in children and thus rarely reported in literature. Pediatric patients with large hydatid cysts can have grave complications due to mass effect. Postoperative bile leak is the most common morbidity and continues to be a challenge for the treating surgeon.Case presentationA 7-year-old boy diagnosed with a giant hydatid cyst of the liver, almost replacing the right lobe, and underwent a laparotomy and excision of cyst with tube drainage. He developed postoperative major bile leak which did not subside even after a redo laparotomy and closure of the suspected bile leak areas. The child underwent a third laparotomy after a hepatobiliary scintigraphy (HIDA scan) which confirmed a persisting major leak. A Roux En Y cystojejunostomy was done this time which drained the bile adequately postoperatively with no evidence of bile in the subhepatic drain. Oral feeds were resumed on the fifth postoperative day. He was discharged in a satisfactory condition and is doing well in the follow-up. Repeat HIDA scan showed no evidence of spillage, with adequate bilio-enteric drainage.ConclusionPersistent major bile leak requiring ERCP with sphincterotomy can be managed successfully in children by internal drainage as Roux En Y cystojejunostomy.

Evaluating Giant Hydatid Cysts: Factors Affecting Mortality and Morbidity.

Objective: The aim of this study was to evaluate the prognostic factors affecting morbidity and mortality among patients who underwent surgery for giant pulmonary hydatid cysts in our center.Methods: Data from 283 patients who underwent surgery in our center for pulmonary hydatid cyst between 2008 and 2018 were retrospectively analyzed. Cysts 10 cm in diameter or larger were considered giant hydatid cysts.Results: There were 145 women (51.2%) and 138 men (48.8%). Giant cyst (≥10 cm) was present in 57 patients (20.1%), while the other 226 patients (79.9%) had cysts smaller than 10 cm. Operations were performed using videothoracoscopic approach in 68 patients (24%) and with thoracotomy in 215 patients (76%). Hydatid cysts were on the left side in 129 patients (45.6%), on the right side in 143 patients (50.5%), and bilateral in 11 patients (3.9%). Postoperative morbidity occurred in 29 patients (10.2%). Use of videothoracoscopic surgical approach did not affect morbidity. The mortality rate within the first 90 days was 0.35% (n = 1).Conclusion: Giant cysts are more common in the young age group than in older adults. Regardless of cyst size, surgery should be performed as soon as possible after diagnosis to avoid potential complications.

Giant isolated hydatid lung cyst: two\xa0case reports\xa0

BackgroundEchinococcosis is a parasitic disease caused by Echinococcus granulosus and causes cystic lesions in the liver and lungs commonly. It is endemic in many parts of the world, and though humans are incidental hosts of the parasite, the disease can have severe consequences.Case presentationWe present two patients from pastoralist (Maasai) communities in rural Tanzania with long-standing chest pain accompanied by hemoptysis. Both were managed surgically after diagnosis, but one patient died of the complications following rapture of the cyst during surgery. Histopathological evaluation of the specimens confirmed the diagnosis of giant hydatid cysts.ConclusionAnimal-keeping communities such as the Maasai are at risk of echinococcosis because of their close proximity to animals. The diagnosis can be made on the basis of history and radiological as well as laboratory findings. Surgery is a recommended mode of treatment, though it carries a high risk, especially when the cyst ruptures. Primary preventive measures are thus necessary in order to avoid the secondary and tertiary complications of the management of giant hydatid cysts, which is difficult in resource-limited endemic areas.

Evaluation of Prognostic Factors Associated with Postoperative Complications Following Pulmonary Hydatid Cyst Surgery.

Background:Hydatid cysts are one of the serious complications following echinococcus infection. The liver and the lungs are the most affected organs, respectively. The severity of the disease is associated with the increase in the number and the size of the cysts, cysts rupture, and systemic effects. The aim of this study is to evaluate prognostic factors that are associated with the increased incidence of postoperative complications following pulmonary hydatid cyst surgery.Methods:Patients referred to Madani hospital from 2014-2018, presenting pulmonary hydatid cysts were included in this study. All the patients were evaluated based on the following parameters: age, gender, location and size of the cysts, rupture status of the cysts (intact or perforated), type of surgical intervention (capitonnage or segmentectomy) and Erythrocyte Sedimentation Rate (ESR). The factors were then compared with postoperative complications. Statistical analysis of the data obtained was conducted using R-softwareResults:Of 76 patients enrolled in our study, 52.63% were males and 47.36% were female. Air leak complication was reported in 13.15% of the patients and 3.94% of the patients were presented with pleural effusion. Postoperative complications were significantly associated with the perforated (ruptured) cysts p= 0.001, segmentectomy p= 0.013, giant hydatid cysts p= 0.007 and ESR p= 0.014. However, the side of the lung was not significantly related to postoperative complications.Conclusion:Our study reports that perforated cysts, increased size, segmentectomy and abnormal ESR are likely to increase postoperative complications following pulmonary hydatid cysts surgery. Prospective studies with perioperative parameters and greater sample size can help to deduce better inferences.

Intraperitoneal Rupture of a Giant Hydatid Cyst of Liver- Can Emergency Placement of Intraperitoneal Drain Improve Patient Optimisation!

Hydatid cyst remains a global health problem. Intraperitoneal hydatid cyst rupture is a life-threatening complication because it causes serious hemodynamic instability and allergic reactions. No clearly defined guidelines exist for dealing with ruptured cysts or intraperitoneal spillage, though emergency exploration remains the standard approach. We present here a case of a 35 -year- old woman who developed spontaneous rupture of a Giant hepatic hydatid cyst. However, patient could not be taken up for emergency surgery in view of very poor chest condition. She was managed by placement of an intra peritoneal drain and lavage with hypertonic saline. Subsequently, patient underwent two surgeries for definitive treatment of the giant hydatid cyst. At one year of follow- up, patient has no evidence of any recurrent disease. Intraperitoneal drain placement and lavage with hypertonic saline may be considered an option to contain peritoneal implantations while patient is being optimised for exploration.

Diaphragmatic Multivesicular Hydatid Cyst

The hydatid cyst of the diaphragm is defined as the development of a hydatid cyst in the diaphragm muscle. Primary or secondary it stills a rare localization, accounting for 1% of the thoracic locations. We report a case of a hydatid cyst of diaphragm in a 57 -year-old female who was admitted to our clinic for right basithoracic pain. CT reported a giant hydatid cyst including multiple vesicles at the right lower thoracic cavity. Surgical exploration revealed an independent giant diaphragmatic hydatid cyst. We performed cystotomy and more than 100 daughter vesicles were removed from the cyst. The rest of the giant cyst cavity was excised.

Single-incision trocar-less endoscopic management of giant liver hydatid cyst in children.

Introduction:Laparoscopic management of giant hydatid cyst has limitations such as spillage, poor control, difficulties in suctioning the contents through special ports which are not easily available, difficulty in the obliteration of residual cavity and recurrence. We describe single-incision trocar-less endoscopic (SITE) technique which simplifies enucleation and management of residual cavity.Method:Inclusion criteria for these cases were patients having single uncomplicated giant hydatid cyst >5 cm present at the surface of the liver and palpable on clinical examination. The cysts which were <5 cm, multiple, deep-seated and impalpable were excluded from the study.Technique:An incision of 1 cm is marked over the site of the maximum bulge and deepened to open peritoneum, cyst is held with two stay sutures, injection of scolicidal agent and aspiration is done and suction of the cyst content is done. After suction of the contents, 5 mm telescope is inserted, and the cyst cavity is inspected, clearance and cyst procedure is done.Results:In 6 years, 62 cases of giant hydatid cyst fulfilling the inclusion criteria and were taken for SITE technique. SITE was successful in all patients and none needed a conversion. Twenty-nine (46.77%) underwent omentopexy and three (4.83%) underwent SITE capitonnage. There was post-operative biliary leak in one (0.016%) patient who underwent capitonnage, which was managed by prolonged drainage which resolved in 10 days. Mean operative duration was 52 min (30 min to 85 min). Mean follow-up was for 18 months (12–36 months). One (0.016%) patient had cyst recurrence.Discussion:SITE has advantages of endoscopic clearance and does not require special ports which are expensive, technically difficult to use and often unavailable. It allows controlled handling, effective suction and easier management of bile communication. SITE can be a preferred procedure for endoscopic management of giant liver hydatid cysts.Conclusion:SITE management of giant liver hydatid cyst seems to be a reliable treatment modality as it is minimally invasive, efficient, easy to perform and effective.

Unruptured Removal of Giant Intracranial Hydatid Cyst in a 6 Year Old Child

Unruptured Removal of Giant Intracranial Hydatid Cyst in a 6 Year Old Child

Major liver resection in pregnancy: three cases with different etiologies and review of the literature

Background: Major liver resection during pregnancy is extremely rare. When required, the associated physiologic and anatomic changes pose specific challenges and greater risk for both mother and fetusMaterials and methods: Three cases of major liver resection during pregnancy due to different etiologies are presented. The relevant literature is reviewed and discussed.Results: We present three cases of major liver resection due to giant liver hemangioma with Kasabach–Merrit syndrome, giant hydatid cyst, and intrahepatic cholangiocarcinoma, at gestational week (GW) 17, 19, and 30, respectively. All patients had an uneventful postoperative course, continued the pregnancy and gave birth at GW 38.Conclusion: Major liver resection can be performed safely during pregnancy. A multidisciplinary team of surgeons, anesthesiologists and gynecologists, in a highly experienced tertiary hepatobiliary center, should be involved.

The relation between the location and the perforation rate of lung hydatid cysts in children

The pressure, size, and central or peripheral location of lung hydatid cysts are the most studied topics among the factors affecting perforation. The aim of this study is to investigate the relation between the location and the perforation rate of lung hydatid cysts in children. 197 patients under the age of 16 years, who were operated between January 2000 and December 2016 due to pulmonary hydatid cysts, were evaluated retrospectively. Patients who had giant hydatid cysts (n=27), bilateral hydatid cysts (n=24), and more than one cyst in one lung (n=12) were excluded to create a more homogeneous group to enable investigation of the relation between the location and the perforation rates of hydatid cysts. Finally, 134 patients who had only one hydatid cyst were classified into two groups: Group 1 with perforated cysts and Group 2 with intact hydatid cysts. 70.9% of the patients were male. In total, 134 cysts were detected and 41% were perforated. The highest perforation rates were detected in the right middle lobe (70%) and the lingula (66.7%). There was a statistically significant difference between the location of the cysts and the perforation rates (p=0.018). Also hydatid cysts located in the right middle lobe and the lingula had higher postoperative complication rates than hydatid cysts located in the upper and lower lobes (p=0.018). We recommend surgical treatment as soon as possible in children with hydatid cysts located in the right middle lobe and lingula to prevent the risk of perforation.

Spontaneous rupture of giant hydatid cyst of lung into left bronchus: Preoperative diagnosis and treatment

Spontaneous rupture of giant hydatid cyst of lung into left bronchus: Preoperative diagnosis and treatment

Giant liver hydatid cyst: a case report

Giant liver hydatid cyst: a case report

Is Anatomic Lung Resection Necessary in Surgical Treatment of Giant Lung Hydatid Cysts in Childhood?

The aim of this study is to evaluate the results of parenchymal saving methods for giant lung hydatid cysts and to discuss the necessity of anatomic lung resection in childhood. The patients under the age of 16 years who were operated between January 2000 and January 2017 due to pulmonary hydatid cyst were evaluated retrospectively (n = 200). In all, 32 patients who had giant hydatid cyst were included in this study. Parenchymal saving methods (cystotomy-capitonnage) were preferred and decortication was also performed for pleural thickening if needed. No lung resections were applied. Male patients were 53.1%. The mean age was 11.3 ± 3.2 years. The total number of giant cysts was 32. The average size of the cysts was 11 cm. Thirty seven point five percent of the cysts were perforated. Postoperative complication rate was 31.3%. No recurrence and mortality were seen during follow-up period. Considering the high recovery capacity of lung tissue, a chance should be given to recover the existing infection, atelectasis, and parenchymal damage. Especially in areas where hydatid disease is endemic, children may be infected with the parasite again. For these reasons, we do not recommend resection with any indications.

Ishod multivisceralne ehinokokoze - prikaz slučaja

Introduction: The pathogen of multivisceral echinococcosis is the same agent as for single organ echinococcosis: Echinococcus granulosus. According to the consensus of experts under the aegis of the WHO-IWGE-WHO-Informal Working Group on Echinococcosis options of treatment should be: (1) percutaneous treatment, (2) surgery, (3) anti-infective drug treatment or (4) watch and wait approach or combinations thereof. Case report: The presented case was a seven-year-old Caucasian boy, a permanent resident of rural region near Tuzla, Bosnia and Herzegovina, who had a history of asymptomatic giant liver and small lung hydatid cyst (multivisceral echinococcosis). We consider that the patient was in the phase of secondary hydatidosis even before undergoing the first treatment PAIR method of liver and continued with adjunctive chemotherapy. Two weeks after discharge, during the adjunctive chemotherapy he had one of possible complication where pre-existed small lung hydatid cyst got inflamed and performed an abscess mass and potential septic risk, which required surgical and antibiotic treatment. Surgery and early postoperative course were normal and the patient was discharged with recommendation to continue with previously started adjunctive chemotherapy (Albendazol) according to treatment protocol. Conclusion: Most infected persons are asymptomatic and clinical manifestations vary according to the anatomic location of the cyst, so we want to indicate the importance of routine ultrasound screening of preschool children, and eventually X ray chest scan. This case report highlights the necessity of caution with choosing appropriate treatment, even though size of cyst can be irrelevant to take surgical treatment in first line instead of medical therapy.

Giant primary hydatid cyst of spleen: rare case report with brief review of literature

Primary extrahepatic hydatid cysts are rare, and primary splenic hydatid cysts even more so, constituting 2% to 3.5% of all hydatid cysts. We did a retrospective study of four years from Jan 2011 to Dec 2014 and only 24 cases of hydatid cysts were recorded. There was only one case of splenic hydatid cyst. Diagnosis was made with the help imaging modalities like ultrasonography and/or contrast-enhanced computed tomography. Enzyme linked immunosorbent assay for hydatid antibodies tested were done to confirm the diagnosis. Surgery was the main stay of treatment after proper sterilization of cyst cavity.

Giant Splenic Hydatid Cyst in Pediatric Age

Giant hydatid cyst in spleen is rare in the pediatric age group. We came across two cases of giant splenic hydatid cysts in pediatric age group, out of which, one case had pulmonary, liver and splenic hydatid cyst which was managed with single stage approach. As a single stage approach is a novel method with less morbidity, it should be adopted as a preferred method for the management of pulmonary and abdominal hydatidosis. Hydatid cyst is described as a slow growing cyst in literature, but the presentation of giant size hydatid cyst in our 7 and 12 year old child is difficult to explain by this concept of slow growth.

Fatal Rupture of a Giant Hydatid Cyst in an Elderly Patient

Hydatid cyst (HC) disease, which is endemic in Turkey, is mainly located in the liver. Cyst rupture is the most common complication of HC. Ultrasonography (US) and computerized tomography (CT) are the main diagnostic modalities for HC disease. Presented herein was a case of an elderly female patient who died shortly after presenting to the emergency department with severe abdominal pain. A giant HC was detected on initial evaluation by US. However, the presence of significant amounts of free fluid in the peritoneal space following a CT of the abdomen. The patient died despite medical and surgical intervention.

Comparison of Larger Diameter and Multiple Cysts in the Treatment of Giant Hydatid Cysts of Liver

Mehmet Aziret1, Hilmi Bozkurt2, Hasan Erdem2, Sahin Kahramanca1, Ilhan Bali3, Enver Reyhan2, Safa Onel2, Kenan Binnetoglu4, Ali Cihat Yildirim1, Oktay Irkorucu2 1Kars State Hospital, Department of General Surgery Kars, Turkey; 2Adana Numune Training and Research Hospital, Department of General Surgery, Adana, Turkey; 3Firat University Faculty of Medicine, Department of General Surgery, Tekirdag, Turkey; 4Firat University Faculty of Medicine, Department of General Surgery, Elazig, Turkey