Ozturk Safak, Unver Mutlu, Kibar Ozturk Burcin, Kebapci Eyup, Bozbiyik Osman, Erol Varlık, Zalluhoglu Nihat, Olmez Mustafa
Department of General Surgery Clinic, T.C.S.B. Tepecik Teaching and Research Hospital, 35110 Izmir, Turkey.
Department of Radiology, Faculty of Medicine, Ege University, Izmir, Turkey.
Case Rep Surg. 2014;2014:303401. doi: 10.1155/2014/303401. Epub 2014 Mar 26.
Introduction. Hydatid disease (HD) is an infestation that is caused by the larval stage of Echinococcus granulosus. The liver is affected in approximately two-thirds of patients, the lungs in 25%, and other organs in a small proportion. Primary retroperitoneal hydatid cyst is extremely rare. The most common complaint is abdominal pain; however, the clinical features of HD may be generally dependent on the location of the cyst. Case Presentation. A 43-year-old female was admitted with the complaint of abdominal pain. Her physical examination was normal. Computed tomography (CT) revealed a 17 × 11 cm cystic lesion, with a thick and smooth wall that is located among the left liver lobe, diaphragm, spleen, tail of the pancreas, and transverse colon and invading the splenic hilum. Total cystectomy and splenectomy were performed. Pathological examination was reported as cyst hydatid. Discussion. Cysts in the peritoneal cavity are mainly the result of the spontaneous or traumatic rupture of concomitant hepatic cysts or surgical inoculation of a hepatic cyst. Serological tests contribute to diagnosis. In symptomatic and large hydatid peritoneal cysts, surgical resection is the only curative treatment. Total cystectomy is the gold standard. Albendazole or praziquantel is indicated for inoperable and disseminated cases. Percutaneous aspiration, injection, and reaspiration (PAIR) technique is another nonsurgical option.
引言。包虫病(HD)是由细粒棘球绦虫的幼虫阶段引起的一种寄生虫感染。约三分之二的患者肝脏受累,25%的患者肺部受累,其他器官受累的比例较小。原发性腹膜后包虫囊肿极为罕见。最常见的症状是腹痛;然而,包虫病的临床特征通常取决于囊肿的位置。病例报告。一名43岁女性因腹痛入院。她的体格检查正常。计算机断层扫描(CT)显示一个17×11厘米的囊性病变,壁厚且光滑,位于左肝叶、膈肌、脾脏、胰尾和横结肠之间,并侵犯脾门。进行了全囊肿切除术和脾切除术。病理检查报告为囊肿型包虫病。讨论。腹腔内囊肿主要是伴随的肝囊肿自发或外伤性破裂或肝囊肿手术接种的结果。血清学检测有助于诊断。对于有症状的大型腹膜包虫囊肿,手术切除是唯一的治愈性治疗方法。全囊肿切除术是金标准。阿苯达唑或吡喹酮适用于无法手术和播散性病例。经皮穿刺抽吸、注射和再抽吸(PAIR)技术是另一种非手术选择。