Michail O P, Georgiou C, Michail P O, Felekouras E, Karavokyros I, Marinos G, Giannopoulos A, Griniatsos J
First Department of Surgery, Medical School, University of Athens, Laikon Hospital, Athens, Greece.
West Indian Med J. 2007 Sep;56(4):372-5.
A 44-year old male patient with a past medical history of a complete surgical excision of pelvic hydatid cyst two years previously presented with constant pelvic floor pain and plasma IgG anti-echinococcal antibody titres of 14.27 U/mL. Based on that and the imaging findings of abdominal ultrasound (US), Computed Tomography (CT) and Magnetic Resonance (MR) the diagnosis of a recurrent retrorectal pelvic hydatid cyst was made. Three courses of oral albendazole treatment were administered and sixteen weeks later, the patient was admitted for a planned elective operation. At that time, a new CT scan revealed disappearance of the cyst, while the serological tests showed a decrease in the IgG anti-echinococcal antibody titres to 0. 71 U/mL. Four different species of the Echinococcus tapeworm can produce infection in humans. E granulosus and E multilocularis are the most common, causing cystic and alveolar echinococcosis respectively, while E vogeli and E oligarthrus, have only rarely been associated with human infection. Although surgical resection remains the treatment of choice for hydatid disease, the present case could suggest that especially in cases of recurrent intraabdominal extrahepatic hydatid cyst, treatment with albendazole may lead to disappearance of the recurrent cyst therefore, should constitute a first line therapeutic option prior to any planned reoperation.
一名44岁男性患者，两年前曾接受盆腔包虫囊肿完整手术切除，现出现持续性盆底疼痛，血浆IgG抗棘球蚴抗体滴度为14.27 U/mL。基于此以及腹部超声（US）、计算机断层扫描（CT）和磁共振（MR）的影像学检查结果，诊断为复发性直肠后盆腔包虫囊肿。给予三个疗程的口服阿苯达唑治疗，16周后，患者入院接受计划中的择期手术。此时，新的CT扫描显示囊肿消失，而血清学检查显示IgG抗棘球蚴抗体滴度降至0.71 U/mL。棘球绦虫的四种不同种类可感染人类。细粒棘球绦虫和多房棘球绦虫最为常见，分别引起囊性和泡状棘球蚴病，而伏氏棘球绦虫和少节棘球绦虫很少与人类感染相关。尽管手术切除仍然是包虫病的首选治疗方法，但本病例表明，特别是对于复发性腹腔内肝外包虫囊肿，阿苯达唑治疗可能导致复发性囊肿消失，因此，在任何计划中的再次手术之前，应构成一线治疗选择。
