Su Li, Yu Jianqun, Dai Chengzhong, Liu Yin, Peng Liqing
Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
Medicine (Baltimore). 2019 Apr;98(16):e15267. doi: 10.1097/MD.0000000000015267.
Echinococcosis, also called hydatid disease, is a common parasitic infection of the liver. However, echinococcus lesions rarely involve the heart, especially in children.
An 8-year-old child from grazing areas of northwest China was referred to our hospital for the complaint of inpersistent precordial chest pain and left upper quadrant pain for 3 years. Palpation showed hepatomegaly, abdominal palpable mass while inspection abdominal distension. Routine blood tests were within the normal ranges.
Combining the life history in pasture area, imaging features and serology results, it was consistent with the diagnosis of cardiac echinococcosis.
Surgery was performed to evacuate cyst liquid and remove the internal capsule of the cyst.
There was no cystic lesion in heart on ultrasound and her physical condition improved significantly after the surgery. The patient died of hepatic hydatid cyst rupture due to refusing high-risk surgical treatment and other treatment.
We presented a rare case of cystic echinococcosis involving left ventricle in a child, and surgery is an alternative and effective therapy for this lesion due to the cyst rupture or leakage that can result in anaphylaxis. The typical imaging features of the cardiac echinococcosis on cardiac magnetic resonance are presented. Patient prognosis relies on proper treatment of all lesions.
棘球蚴病，又称包虫病，是一种常见的肝脏寄生虫感染。然而，棘球蚴病变很少累及心脏，尤其是在儿童中。
一名来自中国西北部牧区的8岁儿童因反复心前区胸痛和左上腹疼痛3年被转诊至我院。触诊显示肝肿大、腹部可触及肿块，视诊有腹胀。血常规检查结果在正常范围内。
结合牧区生活史、影像学特征及血清学结果，诊断为心脏棘球蚴病。
进行手术以抽出囊液并摘除囊肿内囊。
术后超声检查心脏未见囊性病变，身体状况明显改善。患者因拒绝高风险手术治疗及其他治疗，死于肝包虫囊肿破裂。
我们报道了一例儿童罕见的累及左心室的囊性棘球蚴病病例，由于囊肿破裂或渗漏可导致过敏反应，手术是治疗该病变的一种有效替代方法。本文展示了心脏棘球蚴病在心脏磁共振成像上的典型影像学特征。患者的预后取决于对所有病变的恰当治疗。
