Giordano G, Ialongo P, Amoruso M, Rizzo M I, Di Venere B, Bonomo G M
Facoltà di Medicina e Chirurgia, Università degli Studi di Bari.
Ann Ital Chir. 1999 Sep-Oct;70(5):763-6.
Hydatid hepatic cyst rupture into bile duct is a complication of hydatid disease. The rupture is more frequent in right or left epatic duct and occasionally in common bile duct (7-9%). A 50-year old man came to emergency room owing to jaundice, fever and abdominal pain. TC show an hydatid cyst with daughter's cyst of left liver and dilatation of biliary tree. Laboratory data of significance included an increased of liver function tests (Bilirubin, Alkaline ph., SGOT, SGPT), VES and leukocytosis. The patients was surgically treated, by total pericystectomy, colecystectomy and coledocotomy with lavage o common bile duct; finally we placed one Kehr drainage and two abdominal drainage. After 15 days of postoperative hospitalization patient was discharged. The best treatment of hydatid cyst is total pericystectomy (when possible). An alternative surgical treatment is possible for the presence of communication with biliary tree. ERCP is very important for a correct diagnosis and for a complete surgical treatment.
肝包虫囊肿破入胆管是包虫病的一种并发症。这种破裂在左右肝管更为常见，偶尔也会发生在胆总管（7 - 9%）。一名50岁男性因黄疸、发热和腹痛来到急诊室。CT显示左肝有一个含子囊的包虫囊肿以及胆管树扩张。具有重要意义的实验室检查数据包括肝功能检查（胆红素、碱性磷酸酶、谷草转氨酶、谷丙转氨酶）升高、血沉加快和白细胞增多。该患者接受了手术治疗，包括全囊肿切除术、胆囊切除术和胆总管切开术并冲洗胆总管；最后我们放置了一根克尔引流管和两根腹腔引流管。术后住院15天后患者出院。肝包虫囊肿的最佳治疗方法是全囊肿切除术（如果可能的话）。对于与胆管树相通的情况，可以采用另一种手术治疗方法。内镜逆行胰胆管造影术（ERCP）对于正确诊断和完整的手术治疗非常重要。
