Division of Gastroenterology and Hepatology, Department of Medicine, The American University of Beirut School of Medicine, Beirut, Lebanon.
Division of GI Surgery, The American University of Beirut School of Medicine, Beirut, Lebanon ; Department of Diagnostic Radiology, The American University of Beirut School of Medicine, Beirut, Lebanon.
Endosc Ultrasound. 2013 Oct;2(4):225-7. doi: 10.4103/2303-9027.121246.
Hydatid disease is one of the relatively common infections in the Middle Eastern countries. It is seen in areas where dogs are used to raise livestock. In humans, the majority of Echinococcus cysts tends to develop in the liver (70%) and is asymptomatic. The two most common complications of hydatid cysts are abscess formation and rupture. Furthermore, in 5-25% of patients, rupture occurs into the biliary tract and patients may present with cholangitis, jaundice, abscess, or bilio-cutaneous fistula after surgery. Intraductal ultrasound (IDUS) is reportedly superior to conventional endoscopic ultrasound for the depiction of bile duct obstruction owing to its additional capability of providing higher resolution images due to the use of higher frequency transducers. Unfortunately IDUS is rarely used, possibly due to the limited availability of appropriate IDUS equipment, cost of the procedure and interventional endoscopists trained in its interpretation. IDUS with wire-guided, thin-caliber, high-frequency probes is a promising imaging modality, yet no previous reports discuss its usefulness in hydatid disease investigation. We hereby present the first report of biliary hydatid disease being diagnosed by IDUS.
包虫病是中东国家较为常见的感染病之一。它在使用狗来饲养家畜的地区较为常见。在人类中，大多数包虫囊肿倾向于在肝脏中发展（70%），且无症状。包虫囊肿的两个最常见的并发症是脓肿形成和破裂。此外，在 5-25%的患者中，破裂会进入胆道，患者在手术后可能会出现胆管炎、黄疸、脓肿或胆-皮瘘。据报道，由于其使用更高频率的换能器提供更高分辨率的图像的额外能力，腔内超声（IDUS）在显示胆管阻塞方面优于常规的内镜超声。不幸的是，IDUS 很少使用，可能是由于适当的 IDUS 设备的有限可用性、程序的成本以及接受其解释培训的介入内镜医生。带有导丝的、细径、高频探头的 IDUS 是一种很有前途的成像方式，但以前没有报告讨论其在包虫病研究中的有用性。我们在此报告首例通过 IDUS 诊断的胆道包虫病。
