Erel Serap, Kilicoglu Bulent, Kismet Kemal, Gollu Avni, Akkus Mehmet Ali
Ankara Training and Research Hospital, 4th Surgical Clinic, Ankara, Turkey.
Adv Ther. 2008 Sep;25(9):943-50. doi: 10.1007/s12325-008-0088-9.
In hydatid cyst disease, perforation and spontaneous fistula formation are rare, yet very serious, complications. In this study we describe five cases of hydatid cyst disease in which the cysts perforated.
In this retrospective study we evaluated five patients who were surgically treated for perforated hydatid cysts between 2002 and 2006. All patients were admitted to a local hospital with acute abdominal symptoms.
The mean age of the patients (four males and one female) was 39 years. The perforations occurred spontaneously in four patients, and were the result of trauma in one. Three of the hydatid cysts were located in the liver and two in the spleen. Only one patient had a recurrent hydatid cyst. Diagnostic tools included ultrasonography (n=5), computerized tomography (n=1), and diagnostic peritoneal lavage (n=1). The cysts were treated by radical (n=2) or conservative (n=3) methods. There was no postoperative morbidity or mortality, and no recurrences of hydatid disease after follow-up (mean: 14 months).
Cyst perforation in the peritoneal cavity is a serious complication of hydatid disease and should be treated immediately. The literature suggests that recurrences may be related to the operative technique, the location of the cyst, and inadequate irrigation of the peritoneal cavity with scolicidal agents. The findings of this study suggest that if treated promptly, cyst perforation can be successfully treated.
在包虫囊肿病中，囊肿穿孔和自发形成瘘管是罕见但非常严重的并发症。在本研究中，我们描述了5例包虫囊肿病囊肿发生穿孔的病例。
在这项回顾性研究中，我们评估了2002年至2006年间因包虫囊肿穿孔接受手术治疗的5例患者。所有患者均因急性腹部症状入住当地医院。
患者（4名男性和1名女性）的平均年龄为39岁。4例患者的穿孔为自发发生，1例为外伤所致。3个包虫囊肿位于肝脏，2个位于脾脏。只有1例患者有复发性包虫囊肿。诊断工具包括超声检查（n = 5）、计算机断层扫描（n = 1）和诊断性腹腔灌洗（n = 1）。囊肿采用根治性（n = 2）或保守性（n = 3）方法治疗。术后无并发症或死亡，随访（平均14个月）后无包虫病复发。
腹腔内囊肿穿孔是包虫病的严重并发症，应立即治疗。文献表明，复发可能与手术技术、囊肿位置以及腹腔内杀头节剂冲洗不充分有关。本研究结果表明，如果及时治疗，囊肿穿孔可以得到成功治疗。
