1
|
Vantankhah A, Ameri L, Bahrami Taqanaki P, Bayat MJ, Parvizi Mashhadi M. A 16-year-old adolescent with a history of minor abdominal trauma diagnosed with a giant isolated primary splenic hydatid cyst: a case report. Ann Med Surg (Lond) 2024; 86:2292-2295. [PMID: 38576966 PMCID: PMC10990299 DOI: 10.1097/ms9.0000000000001851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 02/11/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Hydatosis is a zoonotic parasitic disease caused by echinococcosis larval infection. South America, Africa, the Middle East, South Europe, India, and Australia are endemic to this disease. Splenic involvement is a rare and complicated hydatid disease presentation. A splenic hydatid cyst is an infrequent clinical occurrence, even in regions where the disease is endemic. Case presentation A 16-year-old male, having a background of mild abdominal trauma and non-resolving dull abdominal pain attended a paediatric surgical outpatient office and following a thorough examination, was diagnosed with a giant solitary isolated splenic hydatid cyst. Subsequently, the patient received albendazole and underwent total splenectomy, necessitated by the considerable size of the cyst, classified as a giant. Clinical discussion Splenic involvement of hydatid disease is a rare presentation (0.5-8%.). With the initial clinical finding often involving the accidental discovery of a palpable mass, the most frequently reported symptoms and signs include the presence of a palpable mass, fever, dull pain, or splenomegaly. Ultrasound and computed tomography are the most helpful tools for evaluating focal splenic diseases. The preferred treatment involves the use of antihelminthic drugs such as albendazole or mebendazole in conjunction with splenectomy. Total splenectomy is the preferred approach and is associated with decreased hospital stay, reduced healthcare costs, and a lower likelihood of recurrence. Conclusion in endemic areas, in patients with splenic cysts, hydatidosis should be contemplated.
Collapse
|
2
|
Yosra K, Ghada H, Bochra A, Fatma T, Said J, Riadh J. Predictive Factors of Liver Hydatid Cyst Recurrence in Children. J Pediatr Surg 2023; 58:2362-2367. [PMID: 37500372 DOI: 10.1016/j.jpedsurg.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Liver hydatid cyst affects approximately 95% of the world's echinococcosis cases. Despite advances in treatment, the recurrence rate remains high and is influenced by several factors that are yet to be determined. The objective of this study was to identify the predictive factors of liver hydatid cyst recurrence following surgery in children and to establish a treatment regimen aimed at preventing this postoperative morbidity. METHODS A bi-centric retrospective descriptive and analytic study was conducted involving 122 children who underwent surgery for liver hydatid cysts between January 1st, 2009, and December 31st, 2017. All factors that could potentially contribute to recurrence were thoroughly investigated. The data was processed using SPSS.v21, and a significant level of p-value 0.05 was applied. RESULTS Out of the 122 children, 20 patients experienced cyst recurrence (16.39%). Among them, there were nine girls and eleven boys. The median time of recurrence was 16.5 months. Abdominal ultrasonography demonstrated efficacy in detecting recurrence. Several factors were identified as predictors of postoperative recurrence, including intimate contact of the hydatid cyst with the large vessels (p = 0.031), intraperitoneal effusion (p = 0.042), bile duct dilation (p = 0.032), and postoperative spontaneous discontinuation of medical treatment (p = 0.010). Among these factors, two independent risk factors for recurrence were identified: intimate contact of the hydatid cyst with the large vessels (p = 0.011) and the presence of an intraperitoneal effusion (p = 0.018). CONCLUSION Our study has identified several predictors of postoperative recurrence, including two previously undocumented risk factors in the literature. Awareness of these risk factors can assist surgeons in implementing preventive measures to avoid the recurrence of hydatid cysts. LEVEL OF EVIDENCE Prognosis study Level II.
Collapse
Affiliation(s)
- Kerkeni Yosra
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia.
| | - Habachi Ghada
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Aziza Bochra
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Thamri Fatma
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Jlidi Said
- Department of Pediatric Surgery "B", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Jouini Riadh
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| |
Collapse
|
3
|
Çay Ü, Alabaz D, Ö Gündeşlioglu Ö, Tutuş K, K Çil M, Pehlivan UA. Multi-organ/disseminated echinococcosis in children: Case series and review of the literature. J Paediatr Child Health 2022; 58:1193-1200. [PMID: 35262239 DOI: 10.1111/jpc.15942] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/24/2022] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Abstract
AIM Echinococcosis with multi-organ/disseminated involvement is rare in childhood. We aimed to evaluate the clinical and laboratory characteristics and prognosis in paediatric patients with echinococcosis having multiorgan/disseminated involvement. METHOD We evaluated retrospectively children with echinococcosis with involvement of three or more organs. RESULTS Thirteen patients were included in the study. The median age was 120 (range 71-189) months. Three (23%) were diagnosed incidentally. Abdominal pain was seen in 5 (38.4%) patients, vomiting in 4 (30.7%), headache in 3 (23%), cough in 2 (15.3%), groin pain in 1 (7.6%), 1 (7.6%) had jaundice and 1 (7.6%) had fever. The median duration of complaints was 48 (0-140) days. The most common tripartite organ was 38.4% (5/13) liver, lung and spleen. Isolated abdominal dissemination was detected in two patients. Two patients had multi-organ involvement and multiple cysts with dissemination. Cyst rupture was observed in three of the patients; recurrent urinary tract infection, hydroureteronephrosis, secondary peritonitis with intra-abdominal abscess, and biliary tract fistula were each observed in one patient. Relapse developed in 3 (23%) patients. CONCLUSION Echinococcosis is a very slow growing and complex parasitic disease that affects many organs and tissues. In our study, eosinophilia, recurrence, and complications were seen at a higher rate in paediatric patients with multiorgan involvement, who required repetitive surgeries and long-term medical treatment. However, there are scanty data on risk factors, optimum treatment and prognosis.
Collapse
Affiliation(s)
- Ümmühan Çay
- Department of Pediatric Infectious, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Derya Alabaz
- Department of Pediatric Infectious, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Özlem Ö Gündeşlioglu
- Department of Pediatric Infectious, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Kamuran Tutuş
- Department of Pediatric Surgery, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Merve K Çil
- Department of Pediatric Infectious, Adana City Training and Research Hospital, Adana, Turkey
| | - Umur A Pehlivan
- Department of Radiology, Faculty of Medicine, Çukurova University, Adana, Turkey
| |
Collapse
|
4
|
Meng K, Zhou HQ, An XQ, Wang MM, Cai JP, Liu GH, A JD, Yang JY. Progress in diagnosis and treatment of hepatic cystic echinococcosis in children. Shijie Huaren Xiaohua Zazhi 2022; 30:387-392. [DOI: 10.11569/wcjd.v30.i9.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatic cystic echinococcosis is a zoonotic parasitic disease caused by infection with Echinococcus granulosus that is widely distributed worldwide. As a special population, children are the key population for the prevention and treatment of echinococcosis, and are also the key target for monitoring in large-scale prevention and treatment. The symptoms of hepatic cystic echinococcosis in children are atypical and easy to be misdiagnosed, and irregular treatment can easily lead to recurrence or even death. This paper provides a review of the diagnosis and treatment modalities for hepatic cystic echinococcosis in children.
Collapse
Affiliation(s)
- Kai Meng
- Graduate School of Qinghai University, Xining 810016, Qinghai Province, China
| | - Hong-Qian Zhou
- Graduate School of Qinghai University, Xining 810016, Qinghai Province, China
| | - Xiu-Qing An
- Department of General Surgery, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
| | - Miao-Miao Wang
- Department of General Surgery, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
| | - Jian-Ping Cai
- Department of General Surgery, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
| | - Guang-Hui Liu
- Department of General Surgery, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
| | - Ji-De A
- Department of General Surgery, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
| | - Jin-Yu Yang
- Department of General Surgery, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
| |
Collapse
|
5
|
Elvan-Tuz A, Karadag-Oncel E, Kara-Aksay A, Sarioglu FC, Karadag A, Yilmaz-Ciftdogan D. A rare case series of central nervous system cystic echinococcosis. J Trop Pediatr 2021; 67:6313147. [PMID: 34213543 DOI: 10.1093/tropej/fmab056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION A total of three cases of childhood central nervous system (CNS) echinococcosis with spinal or posterior fossa involvement having rare localizations, have been presented. CASE PRESENTATION A 7-year-old boy with spinal involvement applied to our hospital with left leg weakness and inability to walk. A 16-year-old girl with posterior fossa involvement had peripheral facial paralysis, while a 9-year-old girl had headache and vomiting. These cases, diagnosed with cystic echinococcosis with the necessary laboratory and imaging methods, improved with appropriate medical treatment and surgery. DISCUSSION Especially in endemic areas, it should be kept in mind that cystic echinococcosis may present with CNS involvement and should become to mind in the differential diagnosis when neurological findings are detected. Lay Summary: With this report, we attempted to share our experience with cystic echinococcosis in the spinal region and posterior fossa in three children over 1 year, including a description of associated signs and symptoms as well as laboratory and radiological findings. It should be kept in mind that cystic echinococcosis may present with CNS involvement in endemic areas and should be considered in the differential diagnosis when neurological findings are detected. Afterward, the diagnosis should be confirmed with appropriate laboratory and imaging methods. In these cases, rapid recovery can be achieved with appropriate surgical intervention as well as medical treatment.
Collapse
Affiliation(s)
- Aysegul Elvan-Tuz
- Department of Pediatric Infectious Diseases, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Eda Karadag-Oncel
- Department of Pediatric Infectious Diseases, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ahu Kara-Aksay
- Department of Pediatric Infectious Diseases, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Fatma Ceren Sarioglu
- Department of Radiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ali Karadag
- Department of Neurosurgery, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Dilek Yilmaz-Ciftdogan
- Department of Pediatric Infectious Diseases, Izmir Katip Celebi University, Izmir, Turkey
| |
Collapse
|