Daali M, Hssaida R, Zoubir M, Hda A, Hajji A
Service de chirurgie générale; Hôpital militaire Avicenne, Marrakech, Maroc.
Sante. 2000 Jul-Aug;10(4):255-60.
We carried out a retrospective study of 25 cases of peritoneal hydatidosis. The incidence of this disease was 6.9%, the sex ratio of the patients was about 2/1 and the mean age of the patients was 31.8 years. Peritoneal echinococcal disease was most frequently secondary to the rupture or splitting of hydatid cysts in the liver (84% of cases) or, more rarely, in the spleen (4% of cases). The principal symptoms were unusual abdominal pain and abdominal masses. Ultrasound scan is the radiological method of choice for investigation and for assessing the number of hydatid cysts in the abdomen. It was used in 20 cases in this series and led to diagnosis of the disease in 95% of these cases. The sensitivity of CT scan for topographical diagnosis was about 90%. Serological tests were negative for the five remaining patients. Surgical management depends on the location and number of hydatid cysts and on the general state of the patient. Total cyst removal was performed in ten patients, pericystectomy in nine cases and marsupialization in six cases in which the cysts were located in the Douglas cul-de-sac. None of the patients was treated with albendazole. None of the patients died and the morbidity rate was 20%, due mainly to the hepatic location of the cysts. We observed one case of small bowel occlusion due to a missed daughter vesicle, two abscesses of the residual cavity, one case of pleurisy and one case of unexplained febrile syndrome. No recurrence was observed over a follow-up period of five years.
我们对25例腹膜包虫病患者进行了一项回顾性研究。该疾病的发病率为6.9%，患者的性别比约为2/1，平均年龄为31.8岁。腹膜棘球蚴病最常见于肝内包虫囊肿破裂或裂开后（84%的病例），或较少见的脾内包虫囊肿破裂或裂开后（4%的病例）。主要症状为异常腹痛和腹部肿块。超声扫描是用于检查和评估腹部包虫囊肿数量的首选影像学方法。本系列中有20例患者使用了超声扫描，其中95%的病例借此得以确诊。CT扫描对定位诊断的敏感性约为90%。其余5例患者的血清学检查均为阴性。手术治疗取决于包虫囊肿的位置和数量以及患者的一般状况。10例患者进行了囊肿全切术，9例进行了囊肿外膜切除术，6例囊肿位于Douglas陷凹的患者进行了袋形缝合术。所有患者均未接受阿苯达唑治疗。无患者死亡，发病率为20%，主要原因是囊肿位于肝脏。我们观察到1例因遗漏子囊导致的小肠梗阻、2例残腔脓肿、1例胸膜炎和1例不明原因的发热综合征。在五年的随访期内未观察到复发。
