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Alzoubi M, Daradkeh S, Daradka K, Shattarat LN, Al-Zyoud A, Al-Qalqili LA, Al-Warafi WA, Al-Nezaa I, ElMoubarek MN, Qtaishat L, Rawashdeh B, Alhajahjeh A. The recurrence rate after primary resection cystic echinococcosis: A meta-analysis and systematic literature review. Asian J Surg 2024:S1015-9584(24)02081-5. [PMID: 39343686 DOI: 10.1016/j.asjsur.2024.09.038] [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: 09/15/2023] [Revised: 09/01/2024] [Accepted: 09/05/2024] [Indexed: 10/01/2024] Open
Abstract
Cystic echinococcosis (CE) is a chronic, complex, zoonotic disease caused by Echinococcus Granulose tapeworms. The disease may present with a variety of symptoms, ranging from asymptomatic to fatal. Surgical intervention is the primary treatment modality for CE. Despite advances in surgical techniques and chemotherapy, disease recurrence remains a major concern. Therefore, we aimed to determine the true rate of CE recurrence after primary resection and identify possible factors that increase the risk of recurrence. A systematic search of Medline, PubMed, Embase, and Cochran Library was conducted to identify studies reporting the incidence of CE recurrence after primary radical surgery. Data were pooled using random effect models. The disease prevalence was determined by calculating the ratio of CE recurrence and the total number of patients. A meta-regression was conducted to identify any potential factors linked to recurrence. A total of 38 eligible studies, with a total of 6,222 CE patients who underwent primary surgical removal, revealed a pooled recurrence rate of 8% (95% CI: 6%-10%). However, significant heterogeneity was observed (I2 p-value <0.001). Subgroup analysis by region showed the highest incidence of recurrence in European and Turkish studies, with rates of 11% (95% CI: 7%-17%) and 9% (95% CI: 5%-14%), respectively. The lowest recurrence rate was observed in Asian studies, with a rate of 4% (95% CI: 2%-7%). Moreover, the non-radical intervention has a recurrence of 5% (95%CI: 4%-7%), radical 7% (95%CI: 6%-9%), and studies that contained both interventions have 10% (95%CI: 6%-16%), P-value= 0.04. This is the first meta-analysis to evaluate the overall incidence of CE recurrence after primary surgical removal. The study also revealed a substantial degree of heterogeneity across the included studies and indicated possible risk factors for higher recurrence rates, such as the study's geographic area, type of surgery and the year it was published. These findings will help to guide future research in developing effective strategies to prevent or reduce CE recurrence and improve patient outcomes.
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Affiliation(s)
| | - Salam Daradkeh
- The University of Jordan, General Surgery Department, Jordan.
| | - Khaled Daradka
- The University of Jordan, General Surgery Department, Jordan.
| | | | - Asma Al-Zyoud
- The University of Jordan, School of Medicine, Jordan.
| | | | | | | | | | - Leen Qtaishat
- The University of Jordan, School of Medicine, Jordan.
| | | | - Abdulrahman Alhajahjeh
- The University of Jordan, School of Medicine, Jordan; King Hussein Cancer Center (KHCC), Internal Medicine Department, Jordan.
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Kuang R, Sun B, Xia T, Deng J, Zhou J. Letter to the Editor: Hepatic Echinococcosis Simulating Liver Cancer. Surg Infect (Larchmt) 2024; 25:417-418. [PMID: 38752315 DOI: 10.1089/sur.2023.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Affiliation(s)
- Rong Kuang
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Bo Sun
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Tian Xia
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jiaqi Deng
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jing Zhou
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Ghanimatdan M, Sadjjadi SM, Mikaeili F, Teimouri A, Jafari SH, Derakhshanfar A, Hashemi-Hafshejani S. Therapeutic effect of curcumin nanoemulsion on cystic echinococcosis in BALB/c mice: a computerized tomography (CT) scan and histopathologic study evaluation. BMC Complement Med Ther 2024; 24:143. [PMID: 38575891 PMCID: PMC10993536 DOI: 10.1186/s12906-024-04451-z] [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: 11/25/2023] [Accepted: 03/21/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND This study aimed to determine the therapeutic efficacy of curcumin nanoemulsion (CUR-NE) in mice infected with Echinococcus granulosus sensu stricto protoscoleces. METHODS Forty-two inbred BALB/c mice were divided into seven groups of six animals each. Six groups were inoculated intra-peritoneally with 1500 viable E. granulosus protoscoleces, followed for six months and used as infected groups. The infected groups were named as: CEI1 to CEI6 accordingly. The 7th group was not inoculated and was named cystic echinococcosis noninfected group (CENI7). CEI1 and CEI2 groups received 40 mg/kg/day and 20 mg/kg/day curcumin nanoemulsion (CUR-NE), respectively. CEI3 received nanoemulsion without curcumin (NE-no CUR), CEI4 received curcumin suspension (CUR-S) 40 mg/kg/day, CEI5 received albendazole 150 mg/kg/day and CEI6 received sterile phosphate-buffered saline (PBS). CENI7 group received CUR-NE 40 mg/kg/day. Drugs administration was started after six months post-inoculations of protoscoleces and continued for 60 days in all groups. The secondary CE cyst area was evaluated by computed tomography (CT) scan for each mouse before treatment and on the days 30 and 60 post-treatment. The CT scan measurement results were compared before and after treatment. After the euthanasia of the mice on the 60th day, the cyst area was also measured after autopsy and, the histopathological changes of the secondary cysts for each group were observed. The therapeutic efficacy of CUR-NE in infected groups was evaluated by two methods: CT scan and autopsied cyst measurements. RESULTS Septal calcification in three groups of infected mice (CEI1, CEI2, and CEI4) was revealed by CT scan. The therapeutic efficacy of CUR-NE 40 mg/kg/day (CEI1 group) was 24.6 ± 26.89% by CT scan measurement and 55.16 ± 32.37% by autopsied cysts measurements. The extensive destructive effects of CUR-NE 40 mg/kg/day (CEI1 group) on the wall layers of secondary CE cysts were confirmed by histopathology. CONCLUSION The current study demonstrated a significant therapeutic effect of CUR-NE (40 mg/kg/day) on secondary CE cysts in BALB/c mice. An apparent septal calcification of several cysts revealed by CT scan and the destructive effect on CE cysts observed in histopathology are two critical key factors that suggest curcumin nanoemulsion could be a potential treatment for cystic echinococcosis.
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Affiliation(s)
- Mohamad Ghanimatdan
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mahmoud Sadjjadi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fattaneh Mikaeili
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aref Teimouri
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hamed Jafari
- Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Derakhshanfar
- Department of Comparative Biomedical Sciences, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeideh Hashemi-Hafshejani
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Reddy H, Malali S, Dhondge RH, Kumar S, Acharya S. Hydatidosis: A Rare Case of Multi-organ Involvement. Cureus 2024; 16:e57562. [PMID: 38706998 PMCID: PMC11069619 DOI: 10.7759/cureus.57562] [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: 03/22/2024] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
Echinococcus granulosus is the tapeworm that causes hydatidosis. The liver is the most frequently impacted region, although it can also affect the spleen, lung, and peritoneum. Dogs are the definite hosts, whereas humans are the unintentional accidental hosts. The peritoneum is an unusual site for hydatid cysts. We report the case of a 42-year-old male who had abdominal distension. A CT scan revealed hydatid cysts in the liver, spleen, and peritoneum. The patient was managed conservatively with albendazole and advised for surgical intervention and removal of daughter cysts. This case highlights the uncommon presentation of hydatid disease involving multiple intra-abdominal organs concurrently. The successful management of such cases necessitates a multidisciplinary approach, encompassing accurate diagnosis, timely intervention, and comprehensive treatment strategies. Furthermore, this case emphasizes the importance of clinical suspicion in endemic regions to optimize patient outcomes and enhance quality of life.
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Affiliation(s)
- Harshitha Reddy
- Internal Medicine, Jawaharlal Nehru Medical College, Wardha, IND
| | - Suprit Malali
- Internal Medicine, Jawaharlal Nehru Medical College, Wardha, IND
| | | | - Sunil Kumar
- Internal Medicine, Jawaharlal Nehru Medical College, Wardha, IND
| | - Sourya Acharya
- Internal Medicine, Jawaharlal Nehru Medical College, Wardha, IND
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Sutihar A, Lamichhane D, JanakyRaman G, Arafin MM, Shrestha RJ, Pandey N, Yadav A, Uprety S. Giant Calcified Hepatic Hydatid Cyst: A Case Report. Cureus 2024; 16:e56876. [PMID: 38659532 PMCID: PMC11041523 DOI: 10.7759/cureus.56876] [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: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Hydatid disease is a zoonotic disease caused by the parasite Echinococcus granulosus. It is an endemic disease in many parts of the world. Although humans are incidental hosts of the parasite, the disease sometimes results in fatal consequences. The liver and lungs are the most common sites of infection in humans. We report the case of a 45-year-old female who presented with complaints of right hypochondriac pain, fever, and cough, initially suspected as a case of liver abscess but later diagnosed as a giant calcified hydatid cyst of the liver. Imaging and immunoglobulin G for Echinococcus granulosus helped confirm our diagnosis. Based on her symptoms, the patient was treated symptomatically with analgesics, paracetamol, and an antitussive for pain, fever, and cough, respectively. In terms of definitive care, she was treated with oral albendazole and referred to her home district for necessary surgical intervention.
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Affiliation(s)
- Anshu Sutihar
- Internal Medicine, Dhaka Medical College Hospital, Dhaka, BGD
- Emergency Department, B. P. Smriti Hospital, Kathmandu, NPL
| | - Deepak Lamichhane
- Internal Medicine, Dhaka Medical College Hospital, Dhaka, BGD
- Emergency Department, B. P. Smriti Hospital, Kathmandu, NPL
| | - Gubeanthrey JanakyRaman
- Internal Medicine, Dhaka Medical College Hospital, Dhaka, BGD
- Emergency Department, Hospital Tengku Ampuan Rahimah (HTAR), Klang, MYS
| | | | | | - Niroj Pandey
- Internal Medicine, Dhaka Medical College Hospital, Dhaka, BGD
| | - Anil Yadav
- Internal Medicine, Dhaka Medical College Hospital, Dhaka, BGD
| | - Subash Uprety
- Internal Medicine, Dhaka Medical College Hospital, Dhaka, BGD
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Slavu IM, Gheorghita V, Macovei Oprescu AM, Filipoiu F, Munteanu O, Tulin R, Dogaru IA, Ursuț BM, Tulin A. Primary Retroperitoneal Hydatid Cyst: A Diagnostic and Treatment Conundrum. Cureus 2024; 16:e53842. [PMID: 38465152 PMCID: PMC10924441 DOI: 10.7759/cureus.53842] [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: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Hydatid cysts are caused by accidental egg ingestion of the Echinococcus granulosus parasite. A 24-year-old female was admitted to our hospital for chronic left lumbar pain. Computed tomography (CT) and abdominal ultrasonography identified an 8/12 cm retroperitoneal cyst. The CT results coupled with enzyme-linked immunosorbent assay tests (positive IgG for Echinococcus granulosus) confirmed that the tumor was a hydatid cyst. Treatment consisted of preoperative chemotherapy with albendazole, intraoperative parasite inactivation, laparoscopic partial cystectomy, and drainage. The drain was removed after three days. Chemotherapy was maintained for two years after surgery. No relapse was observed at the six-month reevaluation. In this article, the diagnostic and therapeutic options and resources are discussed and compared with the published literature.
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Affiliation(s)
- Iulian M Slavu
- Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Valeriu Gheorghita
- Infectious Disease, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
| | | | - Florin Filipoiu
- Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Octavian Munteanu
- Obstetrics and Gynaecology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Raluca Tulin
- Anatomy and Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- Endocrinology, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
| | - Iulian A Dogaru
- General Surgery, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
- Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Bogdan M Ursuț
- Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Adrian Tulin
- General Surgery, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
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Mainali S, Sapkota P, Koirala P, K.C N, Bhandari M, Neupane PK. Hydatid hepatopleural fistula causing biliothorax: minimally invasive approach with ERCP stent placement and chest tube drainage: a case report. Ann Med Surg (Lond) 2023; 85:6266-6273. [PMID: 38098537 PMCID: PMC10718347 DOI: 10.1097/ms9.0000000000001438] [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: 06/26/2023] [Accepted: 10/17/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction and importance Biliothorax and hydatid bilio-bronchial fistula (HBBF) are rare complications of hydatid cysts of the liver with high perioperative mortality. Case presentation and clinical discussion The authors here report the case of a patient with a right massive pleural effusion with evidence of HBBF in imaging studies, who underwent surgical resection of a hydatid cyst of the liver 8 years ago. The patient was managed with intercostal chest tube drainage for biliothorax and endoscopic sphincterotomy with biliary stent placement for the re-establishment of internal biliary drainage, which ultimately allowed the fistulous tract to heal without any major surgical intervention. Conclusion This article focuses on the successful management of the HBBF at our institution. Our findings emphasize the significance of early diagnosis and the criticality of implementing aggressive and early interventions to minimize complications and fatalities. By examining this specific case and reviewing existing literature, the authors have determined that endoscopic treatment appears to be a viable, secure, and efficacious option for addressing postoperative HBBF.
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8
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Suleimanov V, Almogaliq W, Alibrahim LO, Alhanabi FH. Giant Hydatid Cyst of the Liver Presenting With Severe Chest Pain and Deformity. Cureus 2023; 15:e45280. [PMID: 37846281 PMCID: PMC10576853 DOI: 10.7759/cureus.45280] [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: 09/14/2023] [Indexed: 10/18/2023] Open
Abstract
Cystic echinococcosis (CE) is a parasitic disease caused by a larval stage (metacestode) of Echinococcus granulosus (E. granulosus), which is still endemic in many countries worldwide, despite the efforts of the World Health Organization (WHO) to reduce the disease burden in those countries. The hydatid cysts of the liver tend to grow gradually over a long period of time and may cause a variety of symptoms, either related to compression of adjacent organs or rupture. Here we report an unusual case of a giant hydatid cyst of the liver presenting to the emergency room (ER) of our hospital with chest deformity and severe chest pain, heralding impending rupture. Considering the very large size of the cyst (26×20 cm) and severe pain, we deemed expeditious surgery to be the best option. Upon surgery, the cyst contents were evacuated, biliary connections were ligated, and measures were taken to prevent the dissemination of the disease into the abdominal cavity. Closed drainage was used since the patient had almost no omentum. The patient received albendazole pre- and postoperatively. The patient was discharged in good condition after one week in the hospital.
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Affiliation(s)
| | - Wasayf Almogaliq
- General Surgery, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Laila O Alibrahim
- General Surgery, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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KURT İ, DEMİR N, CENGİZ N, SOYLU AR, KULA O. An extremely rare presentation of hydatid cyst disease: hepatic artery pseudoaneurysm bleeding and synchronous duodenal fistula. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1186393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Aims: Hydatid cyst disease is a rare cause of upper gastrointestinal bleeding. Peculiarly if it's resulted from a ruptured hepatic artery aneurysm in the hydatid cyst cavity which is fistulated into the duodenum. We here present a case of hepatic artery pseudoaneurysm due to a complicated hydatid cyst with synchronous duodenal fistula.
Case: A 45-year-old male was admitted to the emergency department with hematemesis and hematochezia. The patient had a history of a hydatid cyst of liver and a surgical procedure of lung ecinoccosis. Endoscopy revealed an unusual ulcerated lesion in the duodenum. Yellow membranes were observed in the midst and blood oozing. After unsuccessful endoscopic sclerotherapy, a Computerized Tomography (CT) was performed. CT revealed a ruptured hydatid cyst into the duodenum and bleeding from the formed hepatic artery pseudoaneurysm. Hepatic artery coil embolization was performed urgently and a percutaneous transhepatic drainage catheter was applied to maintain the bile flow. Subsequently, a 10 Fr , 10 cm plastic stent was inserted via Endoscopic Retrograde Cholangiopancreatography (ERCP). The rare complication which was observed after embolization was the hepatic abscess. Although a percutaneous catheter was inserted initially, drainage wasn’t successful. As a last option, surgical debridement was considered.
Conclusion: If a patient who presented with upper gastrointestinal bleeding with a previous history of liver hydatid cyst, cyst complications must be listed as a differential diagnosis. Besides endoscopy, contrast-enhanced CT and ЕRCP are the essential diagnostic and therapeutic approaches.
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Affiliation(s)
- İdris KURT
- Kastamonu Training and Research Hospital
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Calame P, Weck M, Busse-Cote A, Brumpt E, Richou C, Turco C, Doussot A, Bresson-Hadni S, Delabrousse E. Role of the radiologist in the diagnosis and management of the two forms of hepatic echinococcosis. Insights Imaging 2022; 13:68. [PMID: 35394226 PMCID: PMC8994011 DOI: 10.1186/s13244-022-01190-y] [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: 09/18/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
Echinococcosis is a parasitic disease caused by two zoonotic tapeworms (cestodes) of the Echinocococcus genus. It can be classified as either alveolar or cystic echinococcosis. Although the two forms differ significantly in terms of imaging findings, they share similarities in terms of management and treatment. In parallel to medical treatment with albendazole (ABZ), and surgery, historically used in these diseases, various imaging-guided interventional procedures have recently emerged (drainage, stenting, or Puncture, aspiration, injection, and reaspiration (PAIR)). These options open up a new range of therapeutic options. As in oncology, multidisciplinary consultation meetings now play a major role in adapted management and patient care in hepatic echinococcosis. Consequently, diagnostic imaging and interventional expertise have brought radiologists to the fore as important members of these multidisciplinary team. The radiologist will need to evaluate parasite activity in both forms of the disease, to guide the choice of the appropriate therapy from among medical treatment, interventional radiology procedures and/or surgical treatment. Knowledge of the specific complications of the two forms of echinococcosis will also help radiologists to discuss the appropriate treatment and management. The aim of this review is to describe the core knowledge that what a radiologist should possess to actively participate in multidisciplinary meetings about hepatic echinococcosis. We discuss the role of imaging, from diagnosis to treatment, in alveolar (AE) and cystic echinococcosis (CE), respectively.
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Affiliation(s)
- Paul Calame
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France. .,EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Bourgogne Franche-Comté, Besançon, France.
| | - Mathieu Weck
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Andreas Busse-Cote
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Eleonore Brumpt
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Carine Richou
- Department of Hepatology, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Celia Turco
- Department of Digestive Surgery, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Alexandre Doussot
- Department of Digestive Surgery, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Solange Bresson-Hadni
- Laboratoire de Parasitologie-Mycologie, University Hospital Besançon, 25030, Besançon, France.,Centre National de Référence Echinococcoses, University Hospital Besançon, 25030, Besançon, France
| | - Eric Delabrousse
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France.,EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Bourgogne Franche-Comté, Besançon, France
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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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Bhandarwar A, Tandur A, Bharadwaj G, Chatnalkar S, Wagh A, Bakhshi G. Wandering parasite: endoscopic management of hydatid cysts of abdomen encroaching thorax. Surg Endosc 2021; 35:7253-7259. [PMID: 34410500 DOI: 10.1007/s00464-021-08682-w] [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: 01/06/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Minimal access surgery has opened avenues of hybrid approach for abdominal hydatid cysts extending into thorax. This approach of combined laparoscopy and thoracoscopy should be evaluated for its feasibility and efficacy. AIM Present prospective study was designed to highlight the feasibility and utility of endoscopic approach in the management of complex hydatid cyst of the liver and spleen extending into the thorax. MATERIAL AND METHODS Patients undergoing combined Laparoscopy and thoracoscopy for abdominal hydatid cysts extending into thorax over a period of 4 years were included in the study. Their clinical features, investigations, imaging, treatment and duration of hospital stay were studied. Clinical outcomes were assessed with respect to morbidity and mortality using Calvien Dindo scale. RESULTS A total of 15 patients were studied. All patients had thoracic hydatid cysts with liver involvement in 12, splenic involvement in 2, and both liver and spleen in 1 patient. The most common symptom was pain in the abdomen in 11 patients (73.3%) followed by lump in the abdomen in 2 patients (13.33%), and dyspnoea in 2 patients (13.33%). Computed Tomography was diagnostic in all patients. Most common type was Gomez type 1 (7 patients) followed by Gomez type II (3 Patient) and Gomez type III (2 patient). The mean operative time was 120 min. Mean hospital stay was 10 days. Pleural effusion being the commonest postoperative sequelae. CONCLUSION This endoscopic approach for liver and splenic hydatid cyst extending into thorax is feasible and averts morbidities of thoracotomy.
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Affiliation(s)
- Ajay Bhandarwar
- Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Amarjeet Tandur
- Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Guru Bharadwaj
- Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India.
| | - Soumya Chatnalkar
- Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Amol Wagh
- Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Girish Bakhshi
- Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
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Obeid M, Mansour S, Damouny M, Farah A, Halloun K, Marjiyeh R, Ghalia J, Khuri S. A Conservative Management of Spontaneously Ruptured Liver Hydatid Cyst. Gastroenterology Res 2021; 14:125-128. [PMID: 34007355 PMCID: PMC8110234 DOI: 10.14740/gr1373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/11/2021] [Indexed: 11/11/2022] Open
Abstract
Hydatid disease is a zoonotic disease caused mainly by the cestode (tapeworm) Echinococcus granulosus, also known as hydatidosis. It is endemic mainly in areas where dog/horse breeding and sheep farming are common, such as Australia, New Zealand and the Mediterranean region. A rare, yet serious, complication of hydatid cyst of the liver is rupture, which could be spontaneous due to increased intra-cystic pressure or following a traumatic injury of the abdomen. Rupture into the peritoneal cavity may result in an anaphylactic reaction, usually treated by means of emergency surgical intervention. Herein, we present a case of a 55-year-old male patient, known to have liver hydatid cystic disease 3 years ago, who presented to other hospital with acute abdominal pain, tachycardia and hypotension. A computed tomography (CT) scan of the abdomen revealed ruptured liver hydatid cyst into the peritoneal cavity, with free intra-abdominal fluid and dissemination into the mesentery. The patient was treated successfully by conservative means including nil per os (NPO), intravenous fluids, noradrenaline and anthelminthic treatment by albendazole. Two months later the patient underwent laparoscopic resection of the mesenteric as well as the hepatic cyst. The presentation, diagnosis, course of treatment and follow-up are discussed in this report. Reviewing the current English literature reveals that this is the first case to report a successful initial conservative management of spontaneous intraperitoneal rupture of liver hydatid cyst.
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Affiliation(s)
- Miriam Obeid
- General Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Subhi Mansour
- General Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Mira Damouny
- General Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Amir Farah
- General Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Kenan Halloun
- General Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Rozan Marjiyeh
- General Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Jawad Ghalia
- General Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Safi Khuri
- General Surgery Department, Rambam Health Care Campus, Haifa, Israel.,HPB and Surgical Oncology Unit, Rambam Health Care Campus, Haifa, Israel
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Collado-Aliaga J, Romero-Alegría Á, Alonso-Sardón M, Muro A, López-Bernus A, Velasco-Tirado V, Muñoz Bellido JL, Pardo-Lledias J, Belhassen-García M. Complications Associated with Initial Clinical Presentation of Cystic Echinococcosis: A 20-year Cohort Analysis. Am J Trop Med Hyg 2019; 101:628-635. [PMID: 31359859 DOI: 10.4269/ajtmh.19-0019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cystic echinococcosis (CE) is a chronic, complex, and overlooked zoonotic disease caused by Echinococcus granulosus. In humans, it may result in a wide spectrum of clinical manifestations depending on the type of complications, ranging from asymptomatic infection to fatal disease. The primary complications and risk factors associated with CE are not well defined. We performed a retrospective, observational study of inpatients diagnosed with CE from January 1998 to December 2017 in the public health-care system of western Spain. Five hundred and six cases were analyzed. More than half of the patients (302 [59.7%]) were asymptomatic, and the diagnoses were made incidentally. A total of 204 (40.3%) patients had complications associated with CE; 97 (47.5%) were mechanical, 62 (30.4%) were infectious, 15 (7.3%) were immunoallergic, and 30 (14.7%) involved a combination of complications. Mortality was higher in patients with mechanical complications (9.4%) than in patients with infectious complications (5.6%) and in patients with allergic complications (0%) (odds ratio = 19.7, 95% CI, 4.3-89.1, P < 0.001). In summary, CE frequently results in complications, especially in the liver in younger patients and, regardless of other variables, such as size or stage of cyst. Mechanical problems and superinfection are the most frequent complications. CE is an obligatory diagnosis in patients with urticarial or anaphylactoid reactions of unknown cause in endemic areas.
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Affiliation(s)
- Javier Collado-Aliaga
- Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain
| | - Ángela Romero-Alegría
- Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salamanca, Spain
| | - Montserrat Alonso-Sardón
- Área de Medicina Preventiva y Salud Pública, Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salamanca, Spain
| | - Antonio Muro
- Laboratorio de Inmunología Parasitaria y Molecular, Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Amparo López-Bernus
- Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Salamanca, Spain
| | - Virginia Velasco-Tirado
- Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Salamanca, Spain
| | - Juan Luis Muñoz Bellido
- Servicio de Microbiología, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salamanca, Spain
| | - Javier Pardo-Lledias
- Servicio de Medicina Interna, General Hospital of Palencia "Río Carrión", C/Donantes de Sangre, Palencia, Spain.,Departamento de Medicina Interna. Hospital Universitario Marques de Valdecilla, Universidad de Cantabria, IDIVAL, Cantabria, Spain
| | - Moncef Belhassen-García
- Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Paseo San Vicente, Salamanca, Spain
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15
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ÖZKAÇMAZ S. Computed Tomography Findings of Ruptured Hepatic Hydatid Cyst into the Pericardial Space: A Case Report. IRANIAN JOURNAL OF PARASITOLOGY 2019; 14:674-678. [PMID: 32099573 PMCID: PMC7028240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hydatidosis, is a parasitic infestation caused by Echinococcus granulosus. Although the disease most commonly affects liver and lungs, almost all organ and tissue involvements are documented. Rupture into pericardial space which may lead to pericardial effusion, pericarditis and pericardial tamponade, can be seen especially in the patients with cardiac hydatidosis. But rupture of a hepatic hydatid cyst into the pericardial space through a transdiaphragmatic fistula is very rare. In this report, we present imaging findings of a type III hepatic hydatid cyst lesion which ruptured spontaneously into pericardial space and caused pericardial effusion.
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Pathognomonic Signs for Hepatic Hydatid Disease: Snake Sign and Spin Sign. J Gastrointest Surg 2018; 22:1639-1640. [PMID: 29363021 DOI: 10.1007/s11605-018-3692-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 01/10/2018] [Indexed: 01/31/2023]
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Limeme M, Yahyaoui S, Zaghouani H, Ghannouchi M, Khnissi A, Amara H, Letaief R, Bakir D, Kraiem C. Spontaneous intraperitoneal rupture of hepatic hydatid cyst: a rare cause of ascites. BMC Surg 2014; 14:99. [PMID: 25427421 PMCID: PMC4256059 DOI: 10.1186/1471-2482-14-99] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 07/15/2014] [Indexed: 11/21/2022] Open
Abstract
Background Hydatid disease is endemic in certain areas of the world and it is located mostly in the liver. Intraperitoneal rupture is rare. Rupture may result from trauma or may occur spontaneously from increased pressure of the cystic fluid. Ruptured hydatid cyst is a rare cause of ascites, but should be considered in the differential diagnosis, especially in endemic areas. The diagnosis of ruptured hydatid cyst should be prompt because it requires emergency intervention. Case presentation The present case refers to a 62 year old Tunisian male admitted in our institution for diffuse abdominal distension. Physical examination was unremarkable except for the presence of ascites. Abdominal ultrasonography showed a large amount of fluid into the peritoneal cavity associated with many intraperitoneal cysts with a scalloping on the liver. It showed also a heterogeneous cystic lesion of the segment II of the liver. Abdominal computed tomography (CT) revealed in addition a fat infiltration and a thickening of the peritoneum. Thus intraperitoneal hydatid cyst rupture was suspected and emergency laparotomy was performed. A yellow serous fluid , containing many daughter vesicles disseminated through the peritoneal cavity was noted. A mass consistent with a hydatid cyst was noted at segment II of the liver with a tear on the inferior surface. Thus, intraperitoneal rupture of hepatic hydatid cyst was diagnosed. Conclusion The rupture of hydatid cyst into the peritoneal cavity is rare but presents a challenge for the radiologist and the surgeon. This condition is included in the differential diagnosis of ascites in endemic areas.
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Affiliation(s)
| | - Sana Yahyaoui
- Department of Radiology, Farhat Hached hospital, 4000 Sousse, Tunisia.
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