Canbak Tolga, Acar Aylin, Kıvanç Ali Ediz, Başak Fatih, Kulalı Fatma, Baş Gürhan
Department of General Surgery, Umraniye Education and Research Hospital, İstanbul, Turkey.
Department of Radiology, Umraniye Education and Research Hospital, İstanbul, Turkey.
Turkiye Parazitol Derg. 2017 Dec;41(4). doi: 10.5152/tpd.2017.4899.
Hydatid disease is caused by Echinococcus granulosus. Hydatid cysts are commonly located in the liver and lungs. The occurrence of pancreatic hydatid cysts is very rare, even in endemic areas. Sinistral portal hypertension, which is rarely seen, occurs when a pathological process causes splenic vein occlusion. A 26-year-old male patient presented with abdominal pain. He had a history of operation for hydatid cyst of the lung 15 years ago. A left thoracotomy incision scar was observed during his physical examination. Laboratory findings revealed no abnormalities. Abdominal ultrasonography revealed a 96×69-mm lobular, contoured, well-circumscribed cystic lesion with thickened septation. Abdominal magnetic resonance imaging revealed a 100×76-mm smooth, bordered cystic lesion containing septations in the body and tail of the pancreas compressing the splenic artery and vein, causing sinistral portal hypertension. Dilatation was noted in the left gastroepiploic vein. The patient underwent cystotomy. Pancreatic fistula developed during the postoperative follow-up. The patient was discharged in 20 days without postoperative complications. No complications were observed during the follow-up period of 7 months. Surgery should be considered as a more conservative approach.
包虫病由细粒棘球绦虫引起。包虫囊肿通常位于肝脏和肺部。胰腺包虫囊肿的发生非常罕见，即使在流行地区也是如此。脾静脉闭塞时会出现罕见的左侧门静脉高压，这是由病理过程引起的。一名26岁男性患者出现腹痛。他15年前有过肺包虫囊肿手术史。体格检查时发现左侧开胸手术切口瘢痕。实验室检查结果无异常。腹部超声显示一个96×69毫米的小叶状、轮廓清晰、边界清楚的囊性病变，伴有增厚的分隔。腹部磁共振成像显示一个100×76毫米的光滑、有边界的囊性病变，位于胰腺体尾部，有分隔，压迫脾动脉和静脉，导致左侧门静脉高压。胃网膜左静脉扩张。患者接受了囊肿切开术。术后随访期间出现胰瘘。患者在20天后出院，无术后并发症。在7个月的随访期内未观察到并发症。手术应被视为一种更保守的方法。
