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[盆腔包虫囊肿继发腰丛神经病]

[Lumbar plexopathy secondary to pelvic hydatid cyst].

作者信息

Martín-Serradilla J I, Guerrero-Peral A L, Marcos-Alvarez R, Mohamed-Buskri A, Hernández-Carrero M T, Zatarain-Vázquez M T

机构信息

Servicio de Medicina Interna, Hospital General de Palencia Río Carrión, Palencia, 34005, España.

出版信息

Rev Neurol. 2002;34(10):944-9.

Abstract

INTRODUCTION

Hydatidosis is a zoonosis caused by larvae of the hydatid tapeworm Echinococcus granulosus, which usually affects the liver, lung, myocardium, brain and bones. On rare occasions hydatid cysts give rise to peripheral neurological manifestations.

CASE REPORT

Male, aged 72, who had received a pacemaker as a consequence of a complete auriculoventricular block. During implantation, one hepatic and two pelvic hydatid cysts were discovered. Consulted doctor about right inguinal pain, which irradiated to the lumbar region and along the inner and posterior sides of the thigh, down to the ankle. Exploration revealed a lump in the right iliac fossa and in the lower right limb, hypaesthesia in the anterior side of the thigh, paresis on bending the hip and on extension of the knee, and patellar areflexia. Computerised axial tomography revealed growth of the pelvic cysts and compression of the gluteal veins. Electromyographic exploration of the right quadriceps showed denervation and reinnervation activity.

CONCLUSION

Of all cases of abdominal hydatidosis, 6.7% presented extra hepatic affectation and only 0.7% were seen to have pelvic hydatid cysts. These usually give rise to disorders due to local compression of the genital organs, the urinary tracts, and vascular and bony structures. Lesions in the lumbosacral plexus, however, have only been reported on very few occasions

摘要

引言

包虫病是一种由细粒棘球绦虫幼虫引起的人畜共患病,通常影响肝脏、肺、心肌、脑和骨骼。包虫囊肿极少会引起周围神经症状。

病例报告

一名72岁男性,因完全性房室传导阻滞植入了起搏器。植入过程中,发现一个肝包虫囊肿和两个盆腔包虫囊肿。患者因右腹股沟疼痛前来咨询医生,疼痛放射至腰部,并沿大腿内侧和后侧向下延伸至脚踝。检查发现右髂窝和右下肢有肿块,大腿前侧感觉减退,髋关节屈曲和膝关节伸展无力,髌腱反射消失。计算机断层扫描显示盆腔囊肿增大并压迫臀静脉。右侧股四头肌的肌电图检查显示有失神经和再支配活动。

结论

在所有腹部包虫病病例中,6.7%出现肝外受累,仅有0.7%有盆腔包虫囊肿。这些囊肿通常因局部压迫生殖器官、泌尿道以及血管和骨骼结构而导致病变。然而,腰骶丛病变仅有极少数病例报道。

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