Goyal Vikas Deep, Sood Sanjay, Rana Shelly, Pahwa Sumeet
Department of Cardiothoracic and Vascular Surgery, Dr. Rajendra Prasad Government Medical College, Kangra, Tanda, Himachal Pradesh, India.
Department of Surgery, Dr. Rajendra Prasad Government Medical College, Kangra, Tanda, Himachal Pradesh, India.
Lung India. 2014 Jul;31(3):267-9. doi: 10.4103/0970-2113.135773.
Two patients presented to us with very similar clinical and radiological presentation of huge hydatid cysts in the lung and liver. The first patient was an 11-year-old female child and the second one was a 9-year-old male child. The clinical features in both were breathlessness on exertion, pain abdomen, and abdominal distension. Chest Roentgenogram along with computed tomogram of the chest and abdomen revealed presence of thin-walled homogenous large cysts, one in the right lung and two in the liver, in both the cases. Although the liver cysts were of larger size and occupying most of the right lobe of the liver and part of the left lobe, liver function tests were normal. All three cysts were enucleated in the same sitting by a combined thoracic and abdominal approach (thoracotomy followed by laparotomy). After enucleation of the cyst, capitonnage of the cavity in the lung was done and the liver cavities were filled with omentum to prevent collection of fluid and abscess formation. Both patients recovered well, although the second patient required abdominal drain for a long period of 1 month for bile leakage which decreased gradually and eventually stopped.
两名患者前来就诊,其肺部和肝脏巨大包虫囊肿的临床及影像学表现极为相似。第一名患者是一名11岁女童,第二名是一名9岁男童。两人的临床特征均为活动时呼吸困难、腹痛和腹胀。胸部X线片以及胸部和腹部计算机断层扫描显示,两例均存在薄壁均匀的大囊肿,一例在右肺,两例在肝脏。尽管肝囊肿较大,占据了肝脏右叶的大部分及左叶的一部分,但肝功能检查正常。通过胸腹部联合手术(先开胸再剖腹)一次性摘除了所有三个囊肿。囊肿摘除后,对肺部的腔隙进行了缝合,肝脏的腔隙用大网膜填充,以防止积液和脓肿形成。两名患者恢复良好,不过第二名患者因胆汁漏出,需要长时间放置腹腔引流管1个月,漏液逐渐减少,最终停止。