Hegde Nishchit, Hiremath Bharati
Department of General Surgery, M S Ramaiah Medical College and Hospital, Bangalore, Karnataka, India.
BMJ Case Rep. 2013 Aug 2;2013:bcr2013200435. doi: 10.1136/bcr-2013-200435.
Hydatid disease is a parasitic infestation caused by the tapeworm Echinococcus granulosus. Echinococcosis occurs worldwide and can affect multiple organs. The liver (75%) and the lungs (15%) are the most common sites of occurrence followed by the spleen, kidney, bones and brain. Peritoneal hydatidosis commonly occurs secondary to a ruptured hydatid cyst of the liver or the spleen. Primary peritoneal hydatidosis is an extremely rare entity accounting for just 2% of all intra-abdominal hydatid disease. Most patients remain asymptomatic for years before presenting with vague abdominal symptoms such as non-specific pain, abdominal fullness, dyspepsia, anorexia and vomiting. We successfully treated a 55-year-old woman with primary peritoneal hydatidosis. The role of imaging and immunological tests in the diagnosis is highlighted. The patient was managed by a combination of preoperative and postoperative antihelminthic therapy along with laparotomy, cyst deroofing, toileting and omentoplasty. The patient is asymptomatic at 1-year follow-up.
包虫病是由细粒棘球绦虫引起的一种寄生虫感染。棘球蚴病在全球范围内均有发生，可累及多个器官。肝脏（75%）和肺脏（15%）是最常见的发病部位，其次是脾脏、肾脏、骨骼和大脑。腹膜包虫病通常继发于肝脏或脾脏的包虫囊肿破裂。原发性腹膜包虫病是一种极其罕见的疾病，仅占所有腹腔内包虫病的2%。大多数患者在出现诸如非特异性疼痛、腹部胀满、消化不良、厌食和呕吐等模糊的腹部症状之前，多年来一直无症状。我们成功治疗了一名患有原发性腹膜包虫病的55岁女性。强调了影像学和免疫学检查在诊断中的作用。该患者接受了术前和术后抗蠕虫治疗，并结合剖腹手术、囊肿去顶、清理和网膜成形术进行治疗。在1年的随访中，患者无症状。
