Brecker S J D, Mandal K, Harrison T, Griffin G, Varghese A, Pennell D J, Lester J, Jahangiri M
Department of Cardiology, St George's Hospital, London, UK.
Ann R Coll Surg Engl. 2005 Mar;87(2):W1-4. doi: 10.1308/147870805X28064.
A 27-year-old physical education teacher, from a rural sheep farming area of South Africa, was referred following an isolated episode of collapse. Transthoracic echocardiography and MRI showed a cystic lesion under the septal leaflet of the tricuspid valve attached to the right ventricular wall. A provisional diagnosis of hydatid cyst was made. Hydatid serology was negative and there was no evidence of hydatidosis elsewhere. Preoperatively, the patient was treated with praziquantel and albendazole. Surgery was performed using cardiopulmonary bypass. Cyst was excised without any spillage. The patient was weaned off bypass without any support and made an uneventful recovery. Cytology and microbiology of the specimen confirmed hydatid pathology. This case describes excision of a right ventricular hydatid with techniques used to avoid spillage. It also describes an up-to-date antihelminthic therapy used in the management of hydatid cysts.
一名来自南非农村牧羊区的27岁体育教师，在发生一次孤立的晕厥事件后前来就诊。经胸超声心动图和磁共振成像显示，三尖瓣隔叶下方有一个附着于右心室壁的囊性病变。初步诊断为包虫囊肿。包虫血清学检查为阴性，且其他部位没有包虫病的证据。术前，患者接受了吡喹酮和阿苯达唑治疗。手术采用体外循环进行。囊肿被完整切除，未发生任何渗漏。患者在没有任何辅助的情况下脱离体外循环，恢复顺利。标本的细胞学和微生物学检查证实为包虫病理。本病例描述了右心室包虫的切除手术以及为避免渗漏所采用的技术。它还介绍了用于治疗包虫囊肿的最新抗蠕虫疗法。
