Gulalp B, Koseoglu Z, Toprak N, Satar S, Sebe A, Gokel Y, Sakman G, Karcioglu O
Adana State Hospital, Yuregir, Adana 01330, Turkey.
Neth J Med. 2007 Mar;65(3):117-8.
Hydatid disease is a parasitic infection caused by Echinococcus granulosus characterised by cyst formation in any organ, although the liver is the most commonly involved. Hydatid cysts can rupture either spontaneously or following trauma. Surgical treatment can be life-saving. This paper reports the atypical presentation of a young girl admitted to the emergency department. She presented with pain on her palms due to falling down a few steps. Because of the rebound tenderness on the right upper quadrant of her abdomen on physical examination, bedside ultrasonography was performed to identify the underlying cause, and promptly revealed a 62 x 72 mm lobular cyst on the right lobe of the liver with free fluid in the subcapsular area. Shortly afterwards, urticaria developed. Fluid resuscitation, methylprednisolone and diphenylhydramine were administered intravenously. Afterwards she was taken to the operation room for unroofing, drainage and capitonage. In conclusion, primary care and emergency physicians should perform a complete physical examination on all admitted patients with vague symptoms and a high index of suspicion for a ruptured hydatid cyst, even following trivial trauma, especially in endemic regions.
包虫病是一种由细粒棘球绦虫引起的寄生虫感染，其特征是在任何器官中形成囊肿，尽管肝脏是最常受累的器官。包虫囊肿可自发破裂或在创伤后破裂。手术治疗可能挽救生命。本文报告了一名急诊入院的年轻女孩的非典型表现。她因下了几级台阶而手掌疼痛。由于体格检查时其右上腹有反跳痛，遂进行床边超声检查以确定潜在病因，结果迅速发现肝脏右叶有一个62×72毫米的小叶囊肿，包膜下区域有游离液体。不久后，出现了荨麻疹。给予静脉液体复苏、甲基强的松龙和苯海拉明治疗。之后她被送往手术室进行囊肿开窗、引流和填塞。总之，基层医疗和急诊科医生应对所有因症状模糊而入院且高度怀疑有包虫囊肿破裂的患者进行全面体格检查，即使是在轻微创伤后，尤其是在流行地区。
