Eser Irfan, Karabag Hamza, Gunay Samil, Seker Ahmet, Cevik Muazzez, Ali Sak Zafer Hasan, Yalcin Funda, Aydin Mehmet Salih
Ann Ital Chir. 2014 Jan-Feb;85(1):50-5.
Hydatid cyst is a parasitic disease caused by Echinococcus granulosus whose people is the intermediate host. Although this parasite can settle in any part of the human body, it is frequently seen in liver and lungs. The rate of unusual located hydatid cyst outside of liver and lungs is 13,9%. In this study, we aimed presenting unusual located hydatic cysts regarding 51 patients.
In this retrospective study, the files of the patients operated in our department between 2005 and 2012 with the diagnosis of hydatid cyst, characterized be an additional location besides liver and lung involvement and located outside of liver and lung were controlled.
We had a total of 51 patients between the ages of 6-79 (average age 35,34), 20 of them were men (39%) and the others were women (61%) (men/women = 1.56). The cysts outside of liver and lung were frequently seen in spleen (24/51), ovarium (9/51), intraabdominal (8/51), brain (8/51), kidney (6/51), psoas muscle (1/51), bladder (1/51), cervical lymph node (1/51), the heart(1/51) respectively. The most frequent symptom in our patients was stomachache. Besides, symptoms of cough, fever, respiratory disorder were present; only one patient suffered from hemophtysis. While 32 patient out of 51 were treated by laparotomy, 8 patients were operated with laparotomy and thoracotomy in the same session; the patient with 2 ovarian cysts was submitted to cystectomy through laparoscopic surgery. As a patient had a cyst both in brain and liver, he was submutted to laparotomy and craniotomy. 46 cysts in 9 patients with lung involvement were treated with lung resections: 7 wedges resection and 2 segmentectomies. The other lung cysts of the analysed patients were treated by cystectomy and capitonnage. Bile leakage was detected in a total of 7 patients: 3 of them were treated with T tube drainage and the others were endoscopically healed by means of ERCP.
The incidence of hydatid cyst, which is an important health problem in endemic areas, can be reduced by means of simple preventive measures. Its basic treatment is surgery. Main objective of the surgery should be parenchyma sparing while taking off completely the cysts. Although the disease is frequently seen in liver and lung, other organ involvements should be considered. Thus, it does not matter where hydatid cyst is seen, abdomen and thorax should be attentively controlled by the simplest imaging method also outside of clinical symptoms. Abdomen and thorax imaging should be carried out at least once in the two following years to have an early detection of an eventual recurrence.
包虫囊肿是由细粒棘球绦虫引起的一种寄生虫病，人是其中间宿主。尽管这种寄生虫可寄生于人体的任何部位，但常见于肝脏和肺脏。肝肺外非典型部位的包虫囊肿发生率为13.9%。在本研究中，我们旨在呈现51例非典型部位包虫囊肿患者的情况。
在这项回顾性研究中，我们查阅了2005年至2012年期间在我科接受手术治疗的患者病历，这些患者被诊断为包虫囊肿，其特点是除肝肺受累外还有其他部位受累且位于肝肺外。
我们共有51例年龄在6至79岁之间的患者（平均年龄35.34岁），其中20例为男性（39%），其余为女性（61%）（男/女 = 1.56）。肝肺外的囊肿最常见于脾脏（24/51）、卵巢（9/51）、腹腔内（8/51）、脑（8/51）、肾脏（6/51）、腰大肌（1/51）、膀胱（1/51）、颈部淋巴结（1/51）、心脏（1/51）。我们的患者中最常见的症状是腹痛。此外，还有咳嗽、发热、呼吸紊乱等症状；只有1例患者咯血。51例患者中，32例接受了剖腹手术治疗，8例在同一次手术中接受了剖腹手术和开胸手术；1例有2个卵巢囊肿的患者通过腹腔镜手术进行了囊肿切除术。由于1例患者脑和肝均有囊肿，因此接受了剖腹手术和开颅手术。9例有肺部受累的患者中的46个囊肿接受了肺切除术治疗：7例行楔形切除术，2例行肺段切除术。分析患者的其他肺囊肿通过囊肿切除术和缝合术治疗。总共7例患者检测到胆汁漏：其中3例采用T管引流治疗，其余通过内镜逆行胰胆管造影术（ERCP）治愈。
包虫囊肿在流行地区是一个重要的健康问题，通过简单的预防措施可以降低其发病率。其基本治疗方法是手术。手术的主要目标应是在完全切除囊肿的同时保留实质组织。尽管该病常见于肝脏和肺脏，但也应考虑其他器官受累情况。因此，无论包虫囊肿出现在何处，除临床症状外，还应通过最简单的影像学方法仔细检查腹部和胸部。在接下来的两年中，应至少进行一次腹部和胸部影像学检查，以便早期发现可能的复发。
