El Malki Hadj Omar, El Mejdoubi Yasser, Mohsine Raouf, Ifrine Lahcen, Belkouchi Abdelkader
Clinique chirurgicale A de l'hôpital Ibn Sina, Rabat, Maroc.
Gastroenterol Clin Biol. 2006 Oct;30(10):1214-6. doi: 10.1016/s0399-8320(06)73514-x.
The incidence of the rupture of hydatid cyst of the liver is about 15 to 40% of the cases. In 2 to 7% of the cases the cyst can perforate into the peritoneum. The occurrence of a sclerosing peritonitis secondary to the rupture of the hydatid cyst of the liver was described, to our knowledge, only once. We report the observation of a 43 year-old woman in whom the diagnostis of peritoneal rupture of a liver hydatid cyst was made after 3 months. The patient was treated by albendazole (10 mg/kg/d). Two months after the beginning of this treatment, the patient was operated. A sclerosing peritonitis was discovered. The parasitologic studies of the different specimens were negative. The surgical treatment consisted of a good washing with H2O2 of the fibrous hull of the sclerosing peritonitis and drainage without any dissection. The evolution was satisfactory with albendazole treatment for 14 months. Currently, she is in good health without recurrence and without any abnormalities with a 2 years follow-up. We think that albendazole in the treatment of the hydatid disease is very effective in condition to give a continuous treatment for a long time. The occurrence of a sclerosing peritonitis is fortunately an exceptional situation whose surgical management is very delicate.
肝包虫囊肿破裂的发生率约为病例数的15%至40%。在2%至7%的病例中，囊肿可穿破进入腹膜。据我们所知，肝包虫囊肿破裂继发硬化性腹膜炎的情况仅被描述过一次。我们报告了一例43岁女性的观察病例，该患者在3个月后被诊断为肝包虫囊肿腹膜破裂。患者接受阿苯达唑治疗（10毫克/千克/天）。治疗开始两个月后，患者接受手术。发现为硬化性腹膜炎。对不同标本的寄生虫学研究均为阴性。手术治疗包括用双氧水对硬化性腹膜炎的纤维包膜进行充分冲洗和引流，无需任何解剖。阿苯达唑治疗14个月后病情进展令人满意。目前，经过两年随访，她身体健康，无复发且无任何异常。我们认为，阿苯达唑在治疗包虫病时，在长期持续治疗的情况下非常有效。幸运的是，硬化性腹膜炎的发生是一种特殊情况，其手术处理非常棘手。
