Akbulut Sami, Ozdemir Fatih
Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey.
World J Hepatol. 2019 Mar 27;11(3):318-329. doi: 10.4254/wjh.v11.i3.318.
Most patients with hydatid cysts are asymptomatic, and they are diagnosed incidentally during radiological evaluations performed for other reasons. However, some patients develop symptoms and complications due to cyst size, location, and the relationship between the cyst and adjacent structures. The most serious complications that can occur are rupture of the cysts into the biliary tract, vascular structures, hollow viscus, and peritoneal cavity. We aimed to describe the management of four cases of intraperitoneal rupture of hydatid cysts.
Four patients aged between 27 and 44 years (two men and two women) were admitted to our clinic with sudden abdominal pain ( = 4), hypotension ( = 3), and anaphylaxis ( = 2). Three of the perforated cysts were located in the liver, and one was located in the spleen. Two patients developed cyst rupture after minor trauma, and the other two developed spontaneous rupture. Enzyme-linked immunosorbent assay IgG results were positive for two patients and negative for the other two. All patients received albendazole treatment after surgical intervention (range: 2-6 mo). Two patients developed hepatic abscesses requiring drainage; one of these patients also developed hydatid cyst recurrence during postoperative follow-up (range: 25-80 mo).
Intraperitoneal rupture is a life-threatening complication of hydatid cysts. It is important to manage patients with surgical intervention as soon as possible with aggressive medical treatment for anaphylactic reactions.
大多数包虫囊肿患者无症状，在因其他原因进行的影像学检查中偶然被诊断出来。然而，一些患者因囊肿大小、位置以及囊肿与相邻结构之间的关系而出现症状和并发症。可能发生的最严重并发症是囊肿破裂进入胆道、血管结构、中空脏器和腹腔。我们旨在描述4例包虫囊肿腹腔内破裂的治疗情况。
4例年龄在27至44岁之间的患者（2名男性和2名女性）因突发腹痛（n = 4）、低血压（n = 3）和过敏反应（n = 2）入住我院。3个穿孔囊肿位于肝脏，1个位于脾脏。2例患者在轻微创伤后发生囊肿破裂，另外2例发生自发性破裂。酶联免疫吸附试验IgG结果2例患者为阳性，另2例为阴性。所有患者在手术干预后均接受阿苯达唑治疗（范围：2 - 6个月）。2例患者发生肝脓肿需要引流；其中1例患者在术后随访期间（范围：25 - 80个月）还出现了包虫囊肿复发。
腹腔内破裂是包虫囊肿的一种危及生命的并发症。对于出现过敏反应的患者，尽快进行手术干预并积极进行药物治疗非常重要。
