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Shen Z, Wang Y, Chen X, Chou S, Wang G, Wang Y, Xu X, Liu J, Wang R. Clinical value of the semi-quantitative parameters of 18F-fluorodeoxyglucose PET/CT in the classification of hepatic echinococcosis in the Qinghai Tibetan area of China. BMC Med Imaging 2024; 24:194. [PMID: 39085759 PMCID: PMC11289940 DOI: 10.1186/s12880-024-01371-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 07/18/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND To investigate the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) semi-quantitative parameters, including the lesion diameter, maximum standardized uptake value (SUVmax), maximum standardized uptake value corrected for lean body mass (SULmax), metabolic lesion volume (MLV), and total lesion glycolysis (TLG), for classifying hepatic echinococcosis. METHODS In total, 20 patients with 36 hepatic echinococcosis lesions were included in the study. Overall, these lesions were categorized as hepatic cystic echinococcosis (HCE) or hepatic alveolar echinococcosis (HAE) according to the pathological results. Multiple semi-parameters including the maximum diameter, SUVmax, SULmax, MLV, and TLG were measured to classify HCE and HAE compared with the pathological results. The receiver operator characteristic curve and area under the curve (AUC) of each quantitative parameter were calculated. The Mann-Whitney U test was used to compare data between the two groups. RESULTS In total, 12 cystic lesions and 24 alveolar lesions were identified after surgery. There were significant differences in SUV max, SUL max, MLV, and TLG between the HAE and HCE groups (Z = - 4.70, - 4.77, - 3.36, and - 4.23, respectively, all P < 0.05). There was no significant difference in the maximum lesion diameter between the two groups (Z = - 0.77, P > 0.05). The best cutoffs of SUV max, SUL max, MLV, and TLG for the differential diagnosis of HAE and HCE were 2.09, 2.67, 27.12, and 18.79, respectively. The AUCs of the four parameters were 0.99, 0.99, 0.85, and 0.94, respectively. The sensitivities were 91.7%, 87.5%, 66.7%, and 85.6%, respectively, and the specificities were 90.1%, 91.7%, 83.3%, and 90.9%, respectively. CONCLUSION 18F-FDG PET/CT semi-quantitative parameters had significant clinical value in the diagnosis and pathological classification of hepatic echinococcosis and evaluation of clinical treatment.
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Affiliation(s)
- Zhihui Shen
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Yuan Wang
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Xin Chen
- Department of Pathology, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Sai Chou
- Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Guanyun Wang
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Yong Wang
- Department of Nuclear Medicine, The Fifth Medical Center, Chinese PLA General Hospital, No. 8, Dongdajie Street, Fengtai District, Beijing, 100071, China
| | - Xiaodan Xu
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Jiajin Liu
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Ruimin Wang
- Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
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Mihetiu A, Bratu D, Sabau D, Nastase O, Sandu A, Tanasescu C, Boicean A, Ichim C, Todor SB, Serban D, Hasegan A. Optimized Strategies for Managing Abdominal Hydatid Cysts and Their Complications. Diagnostics (Basel) 2024; 14:1346. [PMID: 39001237 PMCID: PMC11241552 DOI: 10.3390/diagnostics14131346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/16/2024] Open
Abstract
Hepatic hydatid cysts are an example of a zoonosis with global distribution, but with endemic characteristics in certain geographic areas. Known since ancient times, this parasitic infection predominantly affecting the liver and lungs remains a challenge today in terms of diagnosis and the pharmacological, radiological, endoscopic, or surgical therapy. This study analyzed the complications associated with different procedures for treating hydatid cysts in 76 patients admitted to the County Clinical Emergency Hospital of Sibiu. Complications occurred in 18 patients (23.7%), with no significant correlation to age, gender, or residency (urban or rural). Patients undergoing open surgery exhibited the highest complication rate (61.1%) compared to those treated with other procedures. The most frequent complication was biliary duct rupture, occurring in 22.7% of cases. Our findings indicate that the presence of complications significantly prolongs hospitalization time [t df (75) = 12.14, p < 0.001]. Based on these findings, we conclude that the surgical approach for hydatid cysts should be meticulously tailored to each patient's specific circumstances to reduce the risk of complications and improve clinical outcomes.
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Affiliation(s)
- Alin Mihetiu
- Second Surgical Department, Lucian Blaga University of Sibiu, County Clinical Emergency Hospital of Sibiu, 550024 Sibiu, Romania
| | - Dan Bratu
- Second Surgical Department, Lucian Blaga University of Sibiu, County Clinical Emergency Hospital of Sibiu, 550024 Sibiu, Romania
| | - Dan Sabau
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Octavian Nastase
- Radiology Department, County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
| | - Alexandra Sandu
- Second Surgical Department, Lucian Blaga University of Sibiu, County Clinical Emergency Hospital of Sibiu, 550024 Sibiu, Romania
| | - Ciprian Tanasescu
- First Surgical Department, Lucian Blaga University of Sibiu, County Clinical Emergency Hospital of Sibiu, 550024 Sibiu, Romania
| | - Adrian Boicean
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Cristian Ichim
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Samuel Bogdan Todor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Dragos Serban
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest Emergency University Hospital, 050474 Bucharest, Romania
| | - Adrian Hasegan
- Urology Department, Lucian Blaga University of Sibiu, County Clinical Emergency Hospital of Sibiu, 550024 Sibiu, Romania
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Al‐Asbahi H, Jaradat JH, Abu‐Jeyyab M, Al‐Dwairi R, Tailakh BW, Almadadha RA, Alkhawaldeh IM, Nashwan AJ. Intra-biliary hydatid cyst rupture: A rare case report with superinfection. Clin Case Rep 2024; 12:e8581. [PMID: 38500781 PMCID: PMC10944800 DOI: 10.1002/ccr3.8581] [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: 12/04/2023] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/20/2024] Open
Abstract
Key Clinical Message Hydatid cysts, primarily found in the liver (70%), are caused by parasitic infections and can lead to severe complications such as cyst rupture. This case report describes a unique instance of a hydatid liver cyst occupying the right lobe with a communicating part with the biliary tree that ruptured showing a concurrent superinfection. Abstract Hydatid cysts are a clinical pathology resulting from parasitic infections. They may occur in different organs of the body. However, these are mostly found in the liver (70%). This can cause significant complications including cyst rupture. Several case reports have described various hydatid cyst ruptures; however, only a few have reported an intra-biliary hydatid cyst rupture. A 24-year-old male patient presented with right upper quadrant pain, jaundice, dark urine, and pale stool. Imaging studies, including Magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT), revealed a beavertail liver, cystobiliary communication and intrahepatic biliary tree-ruptured hydatid cysts. The cyst was in the right liver lobe, which is the most common site for hydatid cysts. Surgical intervention involving laparoscopic de-roofing and cyst removal resulted in a smooth recovery without complications. Several case reports have described various hydatid cyst ruptures; however, only a few have reported originally placed intra-biliary hydatid cyst ruptures. This case report describes a unique instance of a hydatid liver cyst occupying the right lobe with a communicating part with the biliary tree that ruptured showing a concurrent superinfection.
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Yan L, Chu Z, Yang J, Zhang Y, Liu G, Lei Z, Chen Q, Li J, Yang J, Zhao M, Zhang S, Wu X, Peng X, Zhang H. Multiple cystic echinococcosis in abdominal and pelvic cavity treated by surgery with a 4-year follow-up: a case report. Front Med (Lausanne) 2024; 11:1276850. [PMID: 38304097 PMCID: PMC10830638 DOI: 10.3389/fmed.2024.1276850] [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: 11/09/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024] Open
Abstract
We report a case of a male patient who presented with multiple abdominal and pelvic echinococcosis. The patient had been diagnosed with hepatic echinococcosis for 7 years and developed intermittent distension and discomfort in the upper abdomen after an accidental fall. In recent years, the patient's abdominal distention increased gradually. Computed tomography revealed multiple hydatid cysts in the liver, spleen, abdominal cavity, and pelvic cavity. Abdominal organs were severely compressed, such that he could not eat normally except for a liquid diet. The patient underwent radical surgical resection based on the multi-disciplinary treatment (MDT) and the operation lasted 10 h, nearly 100 hydatid cysts were excised, about 18 liters of cyst fluid and cyst contents were removed, and the patient lost 20 kg of weight after surgery. The operation was successful, but there were still some postoperative complications such as hypovolemic shock, postoperative ascites, postoperative bile leakage. Treatment measures for the patient were anti-infection, antishock, clamping the abdominal drainage tube, and negative pressure abdominal puncture drainage. At follow up the patient's quality of life had been significantly improved with 15 kg weight gain compared to before.
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Affiliation(s)
- Lerong Yan
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
- School of Medicine of Shihezi University, Shihezi, China
| | - Zhiqiang Chu
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Jian Yang
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Yongguo Zhang
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Guisheng Liu
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Zhen Lei
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Qian Chen
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Jiang Li
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Jing Yang
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Meifeng Zhao
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Shijie Zhang
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
- NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Shihezi, China
- Xinjiang Production and Construction Corps Infectious Diseases Clinical Medical Research Center, Shihezi, China
| | - Xiangwei Wu
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
- NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Shihezi, China
- Xinjiang Production and Construction Corps Infectious Diseases Clinical Medical Research Center, Shihezi, China
| | - Xinyu Peng
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
- NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Shihezi, China
- Xinjiang Production and Construction Corps Infectious Diseases Clinical Medical Research Center, Shihezi, China
| | - Hongwei Zhang
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
- NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Shihezi, China
- Xinjiang Production and Construction Corps Infectious Diseases Clinical Medical Research Center, Shihezi, China
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Nayar R, Varshney VK, Hussain S, Yadav T, Puranik A. Left hepatectomy for hepatic hydatid cyst with intra-biliary rupture: Better to be radical. Med J Armed Forces India 2023; 79:S325-S328. [PMID: 38144643 PMCID: PMC10746817 DOI: 10.1016/j.mjafi.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/21/2022] [Indexed: 11/23/2022] Open
Abstract
Echinococcal liver cysts are predominantly located in the right lobe of the liver and are mostly asymptomatic. A frank intra-biliary rupture (IBR) of hydatid cyst is uncommon, having variable clinical presentation and treatment options. We present a case of a 60-year-old male patient who presented with pain in the upper abdomen associated with vomiting but without jaundice. On investigations, he was diagnosed to have a left lobe hepatic hydatid cyst (HHC) with IBR for which left hepatectomy with bile duct exploration was performed. It highlights the benign nature of the disease for which seldom major hepatectomies have to be performed.
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Affiliation(s)
- Raghav Nayar
- Senior Resident (Surgical Gastroenterology), All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vaibhav Kumar Varshney
- Associate Professor (Surgical Gastroenterology), All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sabir Hussain
- Associate Professor (Medical Gastroenterology), Dr. S. N. Medical College, Jodhpur, Rajasthan, India
| | - Taruna Yadav
- Associate Professor (Diagnostic & Interventional Radiology), All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Ashok Puranik
- Professor (Surgical Gastroenterology), All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Kosmidis CS, Papadopoulos K, Mystakidou CM, Sevva C, Koulouris C, Varsamis N, Mantalovas S, Lagopoulos V, Magra V, Theodorou V, Ouzouni S, Iason Katsios N, Axi P, Sapalidis K, Kesisoglou I. Giant Echinococcosis of the Liver with Suppuration: A Case Report and Review of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1070. [PMID: 37374274 DOI: 10.3390/medicina59061070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
Purpose: Cystic echinococcosis (CE) is a common, complex parasitic disease that constitutes a major public health concern. CE demonstrates high endemicity in areas where dogs are used for herding or where animal husbandry practices involve close contact with livestock. It can clinically manifest with a variety of signs and symptoms, such as cholangitis, jaundice, pancreatitis, external biliary fistula, inferior vena cava obstruction, portal hypertension, and superinfection. The latter can notably be related to suppuration, either by rupture or bacteremia. The aim of this study is to report our 76-year-old patient who presented with a primarily infected giant-suppurated hydatid cyst of the liver and its surgical management. Methods: In this case, the diagnosis was based primarily on clinical presentation, computed tomography (CT) scan, and magnetic resonance imaging (MRI) of the patient's abdomen. The surgical procedure of choice was the partial retaining of the pericystic membrane and drainage of the cystic contents (partial pericystectomy). Results: The surgical management and meticulous long-term follow-up of our patient produced a positive outcome without any post-operative complications.
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Affiliation(s)
- Christoforos S Kosmidis
- European Interbalkan Medical Center, 10 Asklipiou Street, 55535 Pylaia, Greece
- 3rd Surgical Department, University General Hospital of Thessaloniki "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
| | - Konstantinos Papadopoulos
- 3rd Surgical Department, University General Hospital of Thessaloniki "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
| | - Chrysi Maria Mystakidou
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Christina Sevva
- 3rd Surgical Department, University General Hospital of Thessaloniki "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
| | - Charilaos Koulouris
- European Interbalkan Medical Center, 10 Asklipiou Street, 55535 Pylaia, Greece
- 3rd Surgical Department, University General Hospital of Thessaloniki "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
| | - Nikolaos Varsamis
- European Interbalkan Medical Center, 10 Asklipiou Street, 55535 Pylaia, Greece
- 3rd Surgical Department, University General Hospital of Thessaloniki "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
| | - Stylianos Mantalovas
- 3rd Surgical Department, University General Hospital of Thessaloniki "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
| | - Vasileios Lagopoulos
- 3rd Surgical Department, University General Hospital of Thessaloniki "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
| | - Vasiliki Magra
- 3rd Surgical Department, University General Hospital of Thessaloniki "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
| | - Vasiliki Theodorou
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Styliani Ouzouni
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Nikolaos Iason Katsios
- Medical School, Faculty of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Paraskevi Axi
- 3rd Surgical Department, University General Hospital of Thessaloniki "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Surgical Department, University General Hospital of Thessaloniki "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
| | - Isaak Kesisoglou
- 3rd Surgical Department, University General Hospital of Thessaloniki "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
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Ahire P, Iyer N, Gada PB. Complication of Hepatic Hydatid Cyst Surgery Presenting as Obstructive Jaundice. Cureus 2023; 15:e35410. [PMID: 36994267 PMCID: PMC10042515 DOI: 10.7759/cureus.35410] [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] [Accepted: 02/24/2023] [Indexed: 03/31/2023] Open
Abstract
The liver is the commonest organ affected by hydatid disease. We report a rare case of a 25-year-old female patient who was treated surgically for hepatic echinococcosis two weeks ago with laparoscopic excision of hepatic hydatid cyst with marsupialization and omentoplasty. She then presented with features of obstructive jaundice, which is a known complication following hydatid endocystectomy. Cholangiogram revealed a communication of the residual hydatid cyst with right segmental intrahepatic biliary radicals. She was treated with endoscopic retrograde cholangiopancreatography (ERCP)-guided stenting. ERCP is regarded as an important therapeutic strategy for hydatid cysts occurring in the extra biliary tree either as primary or as complications of liver cysts. It facilitates the clearing of hydatid debris from the biliary tree, and the closure of fistulas and bile leaks followed by laparoscopic cholecystectomy when the hydatid cysts are also located in the gallbladder.
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Affiliation(s)
- Priya Ahire
- General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND
| | - Nandhini Iyer
- General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND
| | - Parth B Gada
- General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND
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Alsaadawi MA, Al-Safar AHA, Khudhur HR, Abd SM, Hussein HM, Allawi AH, Ali MJ. Histopathological and immunological study of rats liver hydatid cysts isolated from human, sheep, goat and cows. J Parasit Dis 2022; 46:952-966. [PMID: 36457784 PMCID: PMC9606169 DOI: 10.1007/s12639-022-01512-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/13/2022] [Indexed: 11/28/2022] Open
Abstract
In endemic places, liver hydatidosis is a life-threatening health issue. Many consequences such as hepatomegaly, infiltration with inflammatory cells and histopathological changes might arise as a result of liver hydatidosis. This study aimed to look into pathogenic changes in the livers of the rats that experimentally infected with hydatid cysts. These hydatid cysts were isolated from naturally infected humans, sheep, goats and cows. Liver hydatid cysts were collected from the main abattoir of Al-Muthanna province while human hydatid cysts were collected from Al-Hussein Teaching Hospital in Al-Muthanna province. The hydatid cysts were grossly and histology examined for inspection of hydatid cysts. The in vivo experiments were done by injection of hydatid protoscoleces or sand (fluid) in rats intraperitoneally. The results showed that the gross signs were same in all infected livers which range from paleness, hepatomegaly, hemorrhage and calcification. The hydatid cysts isolated from sheep and goat livers were highly fertile compared to others isolated from humans and cows. Injection of hydatid protoscoleces and hydatid fluid isolated from sheep and goat livers in rats induced the highest immune response compared to that isolated from humans and cows. The liver sections of rats that were injected with human, goat and sheep hydatid protoscoleces and fluids showed hyperplasia in the bile duct, aggregation nonnuclear cells with congested blood vessels. While liver sections of rats were received goat hydatid fluid, cow hydatid protoscoleces and hydatid fluid showed normal liver tissue. These findings suggested that the immunogenicity of hydatid materials is different according to the host and the component of hydatid cysts.
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Affiliation(s)
| | | | | | - Saif Mazeel Abd
- Department of Medical Laboratories, College of Medical and Health Techniques, Sawa University, Samawah, Iraq
| | | | | | - Mansour Jadaan Ali
- College of Veterinary Medicine/University of Al-Qadisiyah, Al Diwaniyah, Iraq
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9
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Pompili M, Ardito F, Brunetti E, Cabibbo G, Calliada F, Cillo U, de Sio I, Golfieri R, Grova M, Gruttadauria S, Guido M, Iavarone M, Manciulli T, Pagano D, Pettinari I, Santopaolo F, Soresi M, Colli A. Benign liver lesions 2022: Guideline for clinical practice of Associazione Italiana Studio del Fegato (AISF), Società Italiana di Radiologia Medica e Interventistica (SIRM), Società Italiana di Chirurgia (SIC), Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB), Associazione Italiana di Chirurgia Epatobilio-Pancreatica (AICEP), Società Italiana Trapianti d'Organo (SITO), Società Italiana di Anatomia Patologica e Citologia Diagnostica (SIAPEC-IAP) - Part I - Cystic lesions. Dig Liver Dis 2022; 54:1469-1478. [PMID: 36089525 DOI: 10.1016/j.dld.2022.08.030] [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] [Received: 07/20/2022] [Revised: 08/11/2022] [Accepted: 08/18/2022] [Indexed: 12/29/2022]
Abstract
Benign liver lesions are increasingly diagnosed in daily clinical practice due to the growing use of imaging techniques for the study of the abdomen in patients who have non-specific symptoms and do not have an increased risk of hepatic malignancy. They include simple or parasitic cysts and solid benign tumors which differ widely in terms of prevalence, clinical relevance, symptoms and natural history and often lead to significant clinical problems relating to diagnosis and clinical management. Following the need to have updated guidelines on the management of benign focal liver lesions, the Scientific Societies mainly involved in their management have promoted the drafting of a new dedicated document. This document was drawn up according to the present Italian rules and methodologies necessary to produce clinical, diagnostic, and therapeutic guidelines based on evidence. Here we present the first part of the guideline, concerning the characterization of focal hepatic lesions detected by ultrasound, and the diagnosis and clinical management of simple and parasitic hepatic cysts, and of polycystic liver disease.
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Affiliation(s)
- Maurizio Pompili
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Gemelli Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, Roma 00168, Italy.
| | - Francesco Ardito
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Gemelli Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, Roma 00168, Italy
| | - Enrico Brunetti
- Dipartimento di Scienze Cliniche, Chirurgiche, Diagnostiche e Pediatriche, IRCCS Fondazione Ospedale San Matteo, Università di Pavia, Unità di Malattie Infettive e Immunologia, Pavia, Italy
| | - Giuseppe Cabibbo
- Sezione di Gastroenterologia e Epatologia, Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE) Università di Palermo, Italy
| | - Fabrizio Calliada
- Dipartimento di Radiologia, Fondazione Policlinico San Matteo IRCCS, Università di Pavia, Italy
| | - Umberto Cillo
- Chirurgia Epatobiliare e Trapianto di Fegato, Ospedale Universitario di Padova, Italy
| | - Ilario de Sio
- Epatogastroenterologia, Facoltà di Medicina e Chirurgia, Università della Campania Luigi Vanvitelli, Napoli, Italy
| | - Rita Golfieri
- Dipartimento di Radiologia, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Mauro Grova
- Sezione di Gastroenterologia e Epatologia, Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE) Università di Palermo, Italy
| | - Salvatore Gruttadauria
- Dipartimento per la cura e lo studio delle Patologie Addominali e dei Trapianti Addominali, IRCCS-ISMETT-UPMCI, Dipartimento di Chirurgia e Specialità Medico-Chirurgiche, Università di Catania, Palermo, Italy
| | - Maria Guido
- Dipartimento di Anatomia Patologica, Azienda ULSS2 Marca Trevigiana, Treviso, Italy; Dipartimento di Medicina - DIMED, Università di Padova, Italy
| | - Massimo Iavarone
- Divisione di Gastroenterologia ed Epatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Tommaso Manciulli
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi, Firenze, Italy
| | - Duilio Pagano
- Dipartimento per la cura e lo studio delle Patologie Addominali e dei Trapianti Addominali, IRCCS-ISMETT-UPMC, Palermo, Italy
| | - Irene Pettinari
- Dipartimento di Radiologia, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Francesco Santopaolo
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Gemelli Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, Roma 00168, Italy
| | - Maurizio Soresi
- Medicina Interna, Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE) Università di Palermo, Italy
| | - Agostino Colli
- Dipartimento di Medicina Trasfusionale ed Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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10
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Wu Y, Duffey M, Alex SE, Suarez-Reyes C, Clark EH, Weatherhead JE. The role of helminths in the development of non-communicable diseases. Front Immunol 2022; 13:941977. [PMID: 36119098 PMCID: PMC9473640 DOI: 10.3389/fimmu.2022.941977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/01/2022] [Indexed: 12/15/2022] Open
Abstract
Non-communicable diseases (NCDs) like cardiovascular disease, chronic respiratory diseases, cancers, diabetes, and neuropsychiatric diseases cause significant global morbidity and mortality which disproportionately affect those living in low resource regions including low- and middle-income countries (LMICs). In order to reduce NCD morbidity and mortality in LMIC it is imperative to understand risk factors associated with the development of NCDs. Certain infections are known risk factors for many NCDs. Several parasitic helminth infections, which occur most commonly in LMICs, have been identified as potential drivers of NCDs in parasite-endemic regions. Though understudied, the impact of helminth infections on the development of NCDs is likely related to helminth-specific factors, including species, developmental stage and disease burden. Mechanical and chemical damage induced by the helminth in combination with pathologic host immune responses contribute to the long-term inflammation that increases risk for NCD development. Robust studies from animal models and human clinical trials are needed to understand the immunologic mechanisms of helminth-induced NCDs. Understanding the complex connection between helminths and NCDs will aid in targeted public health programs to reduce helminth-induced NCDs and reduce the high rates of morbidity that affects millions of people living in parasite-endemic, LMICs globally.
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Affiliation(s)
- Yifan Wu
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Megan Duffey
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States,Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, United States
| | - Saira Elizabeth Alex
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Charlie Suarez-Reyes
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Eva H. Clark
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States,Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, United States,National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Jill E. Weatherhead
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States,Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, United States,National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States,*Correspondence: Jill E. Weatherhead,
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11
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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.
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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
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12
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Zouaghi A, Bellil N, Ben Abdallah K, Hadded D, Zaafouri H, Cherif M, Ben Maamer A. Case Report: Portal cavernoma related to multiple liver hydatidosis: A rare case of fatal cataclysmic haemorrhage. F1000Res 2021; 10:1097. [PMID: 34900234 PMCID: PMC8630548 DOI: 10.12688/f1000research.74012.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 02/05/2023] Open
Abstract
Clinical presentation of liver hydatidosis can vary from asymptomatic forms to lethal complications. We report herein a rare case of a 27-year-old male from a rural Tunisian region who presented with large-abundance haematemesis, haemodynamic instability, and marked biological data of hypersplenism. Endoscopy showed bleeding esophageal varicose veins that were ligated. Abdominal ultrasound concluded the presence of three type CE2 hydatic liver cysts causing portal cavernoma with signs of portal hypertension. Despite resuscitation, the patient died of massive rebleeding leading to haemorrhagic shock. Hepatic hydatid cyst should be considered as an indirect cause of gastrointestinal bleeding in endemic countries. Early abdominal ultrasound in varicose haemorrhage is essential in orienting the diagnosis.
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Affiliation(s)
- Alia Zouaghi
- Department of General Surgery, Habib Thameur Hospital, Tunis, 1008, Tunisia
| | - Nawel Bellil
- Department of Gastroenterology, Habib Thameur Hospital, Tunis, 1008, Tunisia
| | | | - Dhafer Hadded
- Department of General Surgery, Habib Thameur Hospital, Tunis, 1008, Tunisia
| | - Haithem Zaafouri
- Department of General Surgery, Habib Thameur Hospital, Tunis, 1008, Tunisia
| | - Mona Cherif
- Department of General Surgery, Habib Thameur Hospital, Tunis, 1008, Tunisia
| | - Anis Ben Maamer
- Department of General Surgery, Habib Thameur Hospital, Tunis, 1008, Tunisia
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13
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Ben Abderrahim S, Gharbaoui M, Békir O, Hamdoun M, Allouche M. Sudden death related to the gastrointestinal system in Tunisia: A 13 year autopsy study. J Forensic Sci 2021; 67:596-604. [PMID: 34897679 DOI: 10.1111/1556-4029.14953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/21/2021] [Accepted: 11/29/2021] [Indexed: 12/20/2022]
Abstract
Sudden gastrointestinal (GI) death is an unexpected death due to digestive system causes mainly found after autopsy. The literature is rich in articles that studied sudden death due to cardiac causes while sudden GI deaths remain less well-documented. We retrospectively investigated all cases of gastrointestinal death at the Department of Forensic Medicine in Tunis, over 13 years (January 1, 2006 to December 31, 2018). Two hundred and eight cases were collected. The mean age of our series was 51.06 ± 20.99 years. No history of digestive disorders was reported in 78.4%, and no family history of sudden death was found in any cases. A male predominance was found in most epidemiological characteristics of the sample with a significant statistical rate in some features. Non-specific abdominal pain was the most described symptom (n = 92). Perforation of GI tract was the common mechanism involved in the death of 55 cases, of which 44 were related to ulcer perforation. These ulcer perforations were statistically more reported in smokers and people suffering from schizophrenia. Intestinal obstruction was the second commonest cause of death, mainly found in the elderly. Sudden death in children was most frequently caused by acute intussusception. This study highlights that systematic study of sudden death due to GI causes might provide opportunities to identify avenues for overall health improvement.
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Affiliation(s)
- Sarra Ben Abderrahim
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Meriem Gharbaoui
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Olfa Békir
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Moncef Hamdoun
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Mohamed Allouche
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
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14
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Surgical management of a hepatic hydatid cyst fistulized into the duodenum: A case report. Int J Surg Case Rep 2021; 88:106518. [PMID: 34768197 PMCID: PMC8591393 DOI: 10.1016/j.ijscr.2021.106518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/10/2021] [Accepted: 10/13/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction and importance Hydatid cyst of liver is a disease usually seen in endemic regions. Fistulization into duodenum is one of the most exceptional complications of the hydatid cyst commonly discovered during surgery. This paper aims to present and discuss a rare case of cyst ruptured into the duodenum. This case report has been reported in line with the SCARE criteria 2020. Case presentation A 44-year-old female patient, previously diagnosed with hydatid cyst of liver with deferred care due to the period of COVID 19 containment, presented with the complaints of abdominal pain and fever. Abdominal CT scan showed up a 2 cm multiseptal hydatid cyst in the segment III of the liver with an exovesiculation of 20 cm, communicating with the first duodenum. The patient underwent antrectomy involving the first duodenum and removing the cystoduodenal fistula with a Roux-en-Y anastomosis. She was discharged with full recovery on the postoperative 5th day. Clinical discussion Clinical features of hydatid cyst fistulized into the duodenum are non-specific. There are two pathognomonic symptoms, hydatidemesis and hydatidenteria.Typically, cysto-duodenal fistula is intra-operatively discovered. The CT scan is the most used morphological examination. The presence of air in the cyst should alert for the gastrointestinal fistula formation. Surgical strategies to perform should be tailored to every patient and to intra operative findings. The post-operative morbidity and mortality are underestimated in the literature. Conclusion The fistulization of Hydatid cyst into the duodenum should be evoked in front of any acute abdominal pain whether or not associated with hydatidemesis or hydatidenteria. Hepatic hydatid cyst fistulized in the duodenum is a potentially fatal condition with non-specific clinical features. Hydatidemesis and hydatidosis are the two pathognomonic symptoms. Fistulized hydatid cyst in the duodenum is often infected and requires urgent surgical management.
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15
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Jaén-Torrejimeno I, Latorre-Fragua R, López-Guerra D, Rojas-Holguín A, Manuel-Vázquez A, Blanco-Fernández G, Ramia JM. Jaundice as a clinical presentation in liver hydatidosis increases the risk of postoperative biliary fistula. Langenbecks Arch Surg 2021; 406:1139-1147. [PMID: 33389115 DOI: 10.1007/s00423-020-02070-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Echinococcosis, also known as hydatidosis, is a zoonosis that is endemic in many countries worldwide. Liver hydatid cysts have a wide variety of clinical manifestations, among which obstructive jaundice is one of the rarer forms. The aims of the study were to analyze the preoperative management of these patients and to record the kind of surgical treatment performed and the short- and long-term postoperative results. METHODS A retrospective two-center observational study of patients operated upon for liver hydatidosis with initial symptoms of obstructive jaundice. Preoperative characteristics, surgical data, and postoperative complications, including biliary fistula, were recorded. RESULTS Of 353 patients operated upon for liver hydatidosis, 44 were included in the study. Thirty-five patients (79.6%) were defined as CE2 or CE3 in the World Health Organization (WHO) classification. Preoperative endoscopic retrograde cholangiopancreatography (ERCP) was performed in 25 patients (56.8%) and identified intrabiliary communication in 29. Radical surgery was carried out in 29 of the total sample (65.9%). Severe postoperative complications (Clavien-Dindo grade IIIA or higher) were recorded in 25% of patients. The factors associated with greater postoperative morbidity were age above 65 (HR 8.76 [95% CI 0.78-97.85]), cyst location (HR 4.77 [95% CI 0.93-24.42]), multiple cysts (HR 14.58 [95% CI 1.42-149.96]), and cyst size greater than 5 cm (HR 6.88 [95% CI 0.95-50]). CONCLUSION The presentation as obstructive jaundice causes greater postoperative morbidity. The main postoperative complication in these cases, despite radical surgery, is biliary fistula. In our series, routine preoperative ERCP did not show any benefit.
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Affiliation(s)
- Isabel Jaén-Torrejimeno
- Department of HBP and Liver Transplant Surgery, University Hospital Complex Badajoz, University of Extremadura, Avda de Elvas s/n, 06080, Badajoz, Spain
| | - Raquel Latorre-Fragua
- Department of HBP, General and Digestive Surgery, University Hospital of Guadalajara, Guadalajara, Spain
| | - Diego López-Guerra
- Department of HBP and Liver Transplant Surgery, University Hospital Complex Badajoz, University of Extremadura, Avda de Elvas s/n, 06080, Badajoz, Spain
| | - Adela Rojas-Holguín
- Department of HBP and Liver Transplant Surgery, University Hospital Complex Badajoz, University of Extremadura, Avda de Elvas s/n, 06080, Badajoz, Spain
| | - Alba Manuel-Vázquez
- Department of HBP, General and Digestive Surgery, University Hospital of Guadalajara, Guadalajara, Spain
| | - Gerardo Blanco-Fernández
- Department of HBP and Liver Transplant Surgery, University Hospital Complex Badajoz, University of Extremadura, Avda de Elvas s/n, 06080, Badajoz, Spain.
| | - José Manuel Ramia
- Department of HBP, General and Digestive Surgery, University Hospital of Alicante, Alicante, Spain
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16
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Akimniyazova B, Kausova G, Yeshmuratov T, Toksanbayev D, Esetova G. Practice of Surgical Treatment for Patients with Combined Echinococcosis of Chest and Abdominal Organs. TANAFFOS 2021; 20:140-149. [PMID: 34976085 PMCID: PMC8710214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/06/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND Epidemiological significance of echinococcosis is determined by the severe clinical progression leading to disability, incapacitation and death, a wide range of hosts, and formation of synanthropic and mixed lesions. The aim of the work was to analyze cases of combined echinococcosis of the chest and abdominal organs and the results of its surgical treatment in clinics of Almaty (Kazakhstan) from 1997 to 2019. MATERIALS AND METHODS In 413 patients, 534 lesions of echinococcosis were revealed: single and multiple cysts. Concurrent echinococcectomy of 2-3 organs was performed in 261 patients; meanwhile phased echinococcectomy was performed in several organs in 152 patients. RESULTS Performed surgical interventions in more than 70% of cases had a favorable outcome. CONCLUSION The choice of rational surgical tactics for combined echinococcosis should be based on an individual approach, taking into account the general condition of the patient, risk analysis and the likelihood of complications.
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Affiliation(s)
- Bekdaulet Akimniyazova
- Kazakhstan’s School of Public Health, Public Health Department, Almaty, Republic of Kazakhstan,,Kazakh National Medical University named after S.D. Asfendiyarova, Pulmonology Department, Almaty, Republic of Kazakhstan,,Modern Medicine Center «MEDITERRA», Department of Thoracic Surgery and Pulmonology, Almaty, Republic of Kazakhstan,,Correspondence to: Akimniyazova B, Address: Kazakhstan’s School of Public Health, Public Health Department, Almaty, Republic of Kazakhstan,
| | - Galina Kausova
- Kazakhstan’s School of Public Health, Public Health Department, Almaty, Republic of Kazakhstan
| | - Temur Yeshmuratov
- Kazakh National Medical University named after S.D. Asfendiyarova, Pulmonology Department, Almaty, Republic of Kazakhstan,,Modern Medicine Center «MEDITERRA», Department of Thoracic Surgery and Pulmonology, Almaty, Republic of Kazakhstan,,Kazakh-Russian Medical University, Department of Surgery, Almaty, Republic of Kazakhstan
| | - Daniyar Toksanbayev
- Kazakh National Medical University named after S.D. Asfendiyarova, Department of Surgical Diseases with a Course of Clinical Anatomy, Almaty, Republic of Kazakhstan,, Modern Medicine Center «MEDITERRA», Department of Hepatopancreatobiliary Surgery and Gastroenterology, Almaty, Republic of Kazakhstan
| | - Gulstan Esetova
- Kazakh National Medical University named after S.D. Asfendiyarova, Pulmonology Department, Almaty, Republic of Kazakhstan
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Predicting the outcome of asymptomatic univesicular liver hydatids: diagnostic accuracy of unenhanced CT. Eur Radiol 2021; 31:5812-5817. [PMID: 33452910 DOI: 10.1007/s00330-020-07681-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 12/14/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To establish the role of unenhanced CT in predicting the outcome of liver hydatid cysts. We sought to determine whether the presence of laminated membrane detachment (LMD) or pericyst degenerative changes (PDCs) detected on CT were reliable signs for predicting a favorable outcome of liver hydatids. METHODS In a 20-year-long study, we prospectively followed changes occurred in CT of 106 cysts of 98 patients with incidentally discovered asymptomatic univesicular liver hydatids who accepted to enter a watch-and-wait program. An "unfavorable" outcome was defined as the occurrence of a complication (most commonly, cyst fistula or infection) or increase in the cyst size during the follow-up; otherwise, the outcome was considered "favorable." The parameters derived from a binary logistic regression analysis (with the outcome taken as the dependent variable), after appropriate transformation of the independent variables (presence of LMD or PDCs on CT), were used to calculate the sensitivity, specificity, positive and negative likelihood ratios, and positive and negative predictive values of the presence of either the abovementioned CT findings for the prediction of a favorable outcome. RESULTS The presence of LMD or PDCs had a high specificity (88%) and positive predictive value (96%) for a favorable outcome; they had high false-negative rates. CONCLUSIONS The presence of either LMD or PDCs on unenhanced CT, in incidentally discovered asymptomatic univesicular liver hydatids, was associated with a high probability of a favorable outcome. Their absence does not rule out a favorable outcome. KEY POINTS • Computed tomography can be used for predicting the outcome of those with incidentally discovered univesicular liver hydatids. • The presence of laminated membrane detachment and/or pericyst degenerative changes is associated with a favorable outcome. • Their absence does not necessarily indicate an unfavorable outcome.
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18
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Fancellu A, Perra T, Vergari D, Vargiu I, Feo CF, Cossu ML, Deiana G, Porcu A. Management of complex liver cystic hydatidosis: challenging benign diseases for the hepatic surgeon: A case series report from an endemic area. Medicine (Baltimore) 2020; 99:e23435. [PMID: 33235127 PMCID: PMC7710265 DOI: 10.1097/md.0000000000023435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Hydatid cysts of the liver are benign lesions which require a wide range of surgical strategies for their treatment. We hypothesized that cysts larger than 15 cm, or compressing main vascular structures, or located in both hemilivers should be considered, as well as complicated cysts, in the category of complex hydatid cysts.In a retrospective study including 55 patients, we evaluated the characteristics of complex hydatid cysts, and compared surgical outcomes between patients operated on for complex cysts (Complex Group) and those operated on for non-complex cysts (non-Complex Group).In the Complex Group, 19% of patients had cysto-biliary communication with recurrent cholangitis, 9.5% had cysts eroding the diaphragm or chest wall, or communicating with the bronchial tree, 31% had cysts with contact with main vascular structures, 11.9% had multiple bilobar cysts, 14.3% had giant cysts with organ displacement, and 14.3% had a combination of the above-mentioned types. Type of surgical treatment was different between the two groups (P < .001). Additional procedures were statistically more frequent in the Complex Group (P = .02). Postoperative morbidity was higher in the Complex Group, although not in a significant manner (P = .07). Median hospital stay was longer in the Complex Group (12 vs 7 days, P < .001). No 30-day mortality occurred. Four patients (7.3%), all belonging to the Complex Group, required reoperation for postoperative complications.Surgery for complex hydatid cysts of the liver is potentially burdened by serious complications. This kind of benign liver disease requires skill-demanding procedures and should be treated in centers with expertise in both hepato-biliary surgery and hydatid disease management.
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