Bedioui H, Chebbi F, Ayadi S, Daghfous A, Bakhtri M, Jouini M, Fteriche F, Ksantini R, Kacem M, Safta Z B
Service de chirurgie A, hôpital La-Rabta, rue Jabbari, 1007 Tunis, Tunisie.
Gastroenterol Clin Biol. 2008 Jan;32(1 Pt. 1):102-6. doi: 10.1016/j.gcb.2007.12.014. Epub 2008 Mar 4.
The pancreas is an uncommon site of a hydatid cyst, even in countries where echinococcal disease is endemic. We report three cases of primary hydatid cysts of the pancreas revealed by abdominal pain. The diagnosis was based on ultrasound and CT-scan, which showed a cystic mass in the tail of the pancreas in the two first cases. In the third case, the diagnosis was determined preoperatively and a pancreatic fistula was found in the head of the pancreas during peroperative cholangiography. The echinococcal immunological test (Elisa) was positive in all cases. Surgical treatment included resection of the prominent lump in two patients and a cystogastric anastomosis in the third. Based on these three cases and a study of the literature, the difficulties of diagnosing this rare disease and the surgical procedures are discussed.
胰腺是包虫囊肿的罕见发病部位,即使在棘球蚴病流行的国家也是如此。我们报告3例因腹痛发现的胰腺原发性包虫囊肿。诊断基于超声和CT扫描,前两例显示胰腺尾部有囊性肿块。第三例术前确诊,术中胆管造影时发现胰头部有胰瘘。所有病例的棘球蚴免疫试验(酶联免疫吸附测定)均为阳性。手术治疗包括2例患者切除突出肿块,第3例患者行囊肿胃吻合术。基于这3例病例并结合文献研究,讨论了诊断这种罕见疾病的困难及手术方法。