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肝囊性包虫病创伤后腹腔内游离破裂:病例系列及文献综述

Posttraumatic free intraperitoneal rupture of liver cystic echinococcosis: a case series and review of literature.

作者信息

Ozturk Gurkan, Aydinli Bulent, Yildirgan M Ilhan, Basoglu Mahmut, Atamanalp S Selcuk, Polat K Yalcin, Alper Fatih, Guvendi Bulent, Akcay M Nuran, Oren Durkaya

机构信息

Department of General Surgery, School of Medicine, Atatürk University, 25240 Erzurum, Turkey.

出版信息

Am J Surg. 2007 Sep;194(3):313-6. doi: 10.1016/j.amjsurg.2006.11.014.

Abstract

BACKGROUND

A serious complication of cystic echinococcus (CE) is the rupture of the cysts. Free intra-abdominal rupture occurs in approximately 3.2% of all cases. Posttraumatic rupture of liver CE is very rare.

METHODS

The objective of the current study was to evaluate the clinical and radiographic findings and surgical treatment of this complication.

RESULTS

Twenty patients with posttraumatic ruptured liver CE were treated. The incidence rate of hydatid rupture was 3.06%. The common presenting symptom was abdominal pain. All patients were operated on under emergency conditions. There were 26 cysts in 20 patients, and all of the cysts were treated surgically.

CONCLUSION

Hydatid cyst rupture must be kept in mind in the management of trauma patients with cystic mass in the liver in particular and free intra-abdominal fluid, especially in the endemic area. We preferred conservative (unroofing associated with various procedures for the management of the residual cavity) rather than radical procedures such as hepatic resection or pericystectomy for the surgical treatment.

摘要

背景

囊性棘球蚴病(CE)的一种严重并发症是囊肿破裂。腹腔内囊肿自发性破裂在所有病例中约占3.2%。肝CE创伤后破裂非常罕见。

方法

本研究的目的是评估这种并发症的临床和影像学表现以及手术治疗方法。

结果

对20例创伤后肝CE破裂患者进行了治疗。包虫囊肿破裂的发生率为3.06%。常见的症状是腹痛。所有患者均在急诊情况下接受手术。20例患者共有26个囊肿,所有囊肿均接受了手术治疗。

结论

在处理特别是肝脏有囊性肿物且腹腔内有游离液体的创伤患者时,尤其是在流行地区,必须考虑到包虫囊肿破裂的情况。手术治疗时,我们更倾向于采用保守方法(囊肿开窗术联合处理残留腔的各种方法)而非根治性手术,如肝切除术或囊肿切除术。

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