Suppr超能文献

胰腺原发性包虫囊肿:病例报告及文献复习

Primary hydatid cyst of pancreas: Case report and review of literature.

作者信息

Ahmed Zeeshan, Chhabra Sanjeev, Massey Ashish, Vij Vikesh, Yadav Rahul, Bugalia Rajendra, Kankaria Jeevan, Jenaw Raj K

机构信息

Department of General Surgery, SMS Medical College and Hospital, JLN Marg, Jaipur-302004, Rajasthan, India.

出版信息

Int J Surg Case Rep. 2016;27:74-77. doi: 10.1016/j.ijscr.2016.07.054. Epub 2016 Aug 2.

Abstract

INTRODUCTION

Hydatid disease is caused by the larval stage of Echinococcus granulosus. It most commonly affects the liver and lung. Pancreatic hydatid cyst (PHC) is very rare with incidence of 0.14%-2%.

PRESENTATION OF CASE

A 40year old lady presented with epigastric pain for last 3 months. A 5×5cm abdominal lump occupying the epigastric and left hypochondrial region was noted on physical examination. Ultrasonography (USG) and Contrast enhanced Computed Tomogrpahy (CT) revealed a 55×57mm cystic structure in the pancreatic body. Endoscopic ultrasound guided fluid aspiration cytology revealed normal Carcinoembryonic antigen and Amylase levels. Cytological examination was noncontributory. During open surgical exploration, it was found to be a hydatid cyst. After irrigation with scolicidal agent and evacuation of cystic contents, Partial cystectomy with external drainage was done. Histopathological biopsy revealed Hydatid cyst. Post-operative ELISA (Enzyme linked immunosorbent assay) for Echinococcal antigen was positive.

DISCUSSION

PHC is a rare entity. Most common mode of spread is hematogenous. Cysts in pancreatic head can present as obstructive jaundice. Cysts in body and tail are usually asymptomatic. USG, CT and Hydaitd serology can help in diagnosis and monitoring recurrence. Surgical exploration is treatment of choice. Options include pericystectomy, partial cystectomy+/- external drainage/omentopexy, marsupialization or cysto-enterostomy. Preoperative and Post-operative anti helminthic (Albendazole) is recommended.

CONCLUSION

PHC can masquerade as pseudocyst or cystic neoplasm of pancreas. It should always be considered in the differential diagnosis of cystic pancreatic lesion in patients from endemic regions.

摘要

引言

包虫病由细粒棘球绦虫的幼虫阶段引起。它最常累及肝脏和肺。胰腺包虫囊肿(PHC)非常罕见,发病率为0.14% - 2%。

病例介绍

一位40岁女性因上腹部疼痛3个月前来就诊。体格检查发现一个5×5cm的腹部肿块,占据上腹部和左季肋区。超声检查(USG)和增强计算机断层扫描(CT)显示胰体部有一个55×57mm的囊性结构。内镜超声引导下液体抽吸细胞学检查显示癌胚抗原和淀粉酶水平正常。细胞学检查无诊断价值。在开放手术探查中,发现是一个包虫囊肿。用杀头节剂冲洗并排空囊内容物后,进行了部分囊肿切除术并外置引流。组织病理学活检显示为包虫囊肿。术后针对棘球蚴抗原的酶联免疫吸附测定(ELISA)呈阳性。

讨论

PHC是一种罕见疾病。最常见的传播方式是血行传播。胰头部的囊肿可表现为梗阻性黄疸。体部和尾部的囊肿通常无症状。USG、CT和包虫血清学检查有助于诊断和监测复发情况。手术探查是首选治疗方法。选择包括囊肿切除术、部分囊肿切除术±外置引流/网膜固定术、袋形缝合术或囊肿肠吻合术。建议术前和术后使用抗蠕虫药(阿苯达唑)。

结论

PHC可伪装成胰腺假性囊肿或囊性肿瘤。在来自流行地区的患者中,囊性胰腺病变的鉴别诊断中应始终考虑到它。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验