Unalp Haluk R, Yilmaz Yeliz, Durak Evren, Kamer Erdinc, Tarcan Ercument
The 4th General Surgery Clinic, Izmir, Turkey.
Saudi Med J. 2010 Jan;31(1):37-42.
To evaluate the clinical presentation and early and long-term outcomes of patients treated surgically for intraperitoneal ruptured liver hydatid cysts.
The medical records of 21 patients with rupture of hydatid cysts were evaluated retrospectively between January 2000 and April 2009 at Izmir Ataturk Training and Research Hospital, Izmir, Turkey, as were the records of 368 patients with hydatid cysts. Age, gender, symptoms, laboratory findings, diagnostic procedures, surgical treatment modalities, in-hospital stay, morbidity, mortality, and recurrence were evaluated.
Sixteen of these patients (76.2%) were women. The mean age was 43.8 years. Cysts were single in 16 cases (76.2%). In 14 cases (66.7%) cysts were localized only in the right lobe. There was also a cyst in the spleen in 4 patients (19%). Simple falls or direct abdominal minor trauma was responsible in 8 patients (38.1%), and pedestrian mishaps in 4 (19%). Nine (42.8%) patients experienced spontaneous rupture. External drainage was performed in 12 (57.1%) patients and omentoplasty in 9 patients (42.8%) to manage the cyst cavity. A total of 11 morbidities developed in 9 patients (42.8%). There was no postoperative mortality. The mean hospital stay was 11.37.4 days, and mean follow-up was 63.131.3 months. The recurrence rate was 23.8%.
The morbidity and recurrence rates of surgical interventions for ruptured hydatid cysts are high. This pathology, although rare, should be included in the differential diagnosis of an acute abdomen in endemic areas.
评估接受手术治疗的腹腔内破裂肝包虫囊肿患者的临床表现以及早期和长期预后。
回顾性评估2000年1月至2009年4月在土耳其伊兹密尔阿塔图尔克培训与研究医院收治的21例包虫囊肿破裂患者的病历，以及368例包虫囊肿患者的病历。对年龄、性别、症状、实验室检查结果、诊断程序、手术治疗方式、住院时间、发病率、死亡率和复发情况进行评估。
这些患者中有16例（76.2%）为女性。平均年龄为43.8岁。16例（76.2%）囊肿为单发。14例（66.7%）囊肿仅局限于右叶。4例（19%）患者的脾脏也有囊肿。8例（38.1%）患者因简单摔倒或腹部轻微直接外伤导致囊肿破裂，4例（19%）因行人意外事故导致。9例（42.8%）患者发生自发性破裂。12例（57.1%）患者进行了外引流，9例（42.8%）患者进行了网膜成形术以处理囊肿腔。9例患者（42.8%）共出现11种并发症。无术后死亡病例。平均住院时间为11.3±7.4天，平均随访时间为63.1±31.3个月。复发率为23.8%。
破裂包虫囊肿手术干预的发病率和复发率较高。这种病理情况虽然罕见，但在流行地区的急腹症鉴别诊断中应予以考虑。
