Atak Burcin, Aktas Gulali, Kocak M Zahid, Duman Tuba, Erkus Edip, Gurel Kamil, Savli Haluk
Department of Internal Medicine, Abant Izzet Baysal University (AIB), Bolu, Turkey.
Department of Radiology, Abant Izzet Baysal University (AIB), Bolu, Turkey.
J Coll Physicians Surg Pak. 2018 Oct;28(10):801-803.
Hydatid cyst is a parasitic infection which causes enormous morbidity and mortality worldwide. The pathogenic organism responsible for hydatid cyst is Echinococcus granulosus. Despite the fact that the characteristic cysts of the disease usually occur in liver and lungs, they may also occur in aberrant localisations. Subjects either present with symptoms of infection itself or local complications due to compressive mass effect of the cyst. Here, we report a case of secondary hypertension due to extrinsic compression of the right renal artery by a giant hepatic hydatid cyst. A 78-year woman presented with poorly controlled hypertension. She has been treated for hypertension with an angiotensin converting enzyme inhibitor plus calcium channel blocker for the last 2 years. Imaging studies revealed narrowing of the right renal artery and external compression, caused by a giant hydatid cyst. The giant hydatid cyst was treated by cyst aspiration and alcohol injection. Despite cessation of angiotensin converting enzyme inhibitor plus calcium channel blocker, she remained normotensive on follow-up visits. New onset and resistant hypertension cases in elderly should be carefully evaluated for secondary causes of hypertension, including renovascular conditions. Mass effect of the hydatid cyst disease should be considered in the differential diagnosis.
包虫囊肿是一种寄生虫感染，在全球范围内都可导致严重的发病率和死亡率。引起包虫囊肿的致病生物是细粒棘球绦虫。尽管该病典型的囊肿通常出现在肝脏和肺部，但也可能出现在异常部位。患者要么出现感染本身的症状，要么出现因囊肿压迫性肿块效应导致的局部并发症。在此，我们报告一例因巨大肝包虫囊肿对右肾动脉的外在压迫导致继发性高血压的病例。一名78岁女性因高血压控制不佳前来就诊。在过去2年里，她一直使用血管紧张素转换酶抑制剂加钙通道阻滞剂治疗高血压。影像学检查显示右肾动脉狭窄及外部压迫，由一个巨大的包虫囊肿引起。通过囊肿抽吸和酒精注射治疗了巨大包虫囊肿。尽管停用了血管紧张素转换酶抑制剂加钙通道阻滞剂，但她在随访中血压仍保持正常。对于老年患者新发和难治性高血压病例，应仔细评估高血压的继发原因，包括肾血管疾病。在鉴别诊断中应考虑包虫囊肿病的肿块效应。
