Gou Li, Gao Feng, Tiheiran Maijudan, Guo Hui
Digestive Internal Medicine, The People's Hospital of Xinjiang Uyghur Autonomous Region, Xinjiang, China.
Medical Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.
Open Forum Infect Dis. 2020 Apr 3;7(5):ofaa118. doi: 10.1093/ofid/ofaa118. eCollection 2020 May.
Hydatid disease is a severe health problem in endemic areas. In recent years, the incidence of this disease in China has been increasing. As the imaging characteristics of pancreatic echinococcosis (PE) are similar to those of cystic diseases, such as cysts, tuberculosis, and tumors, PE is often misdiagnosed and mistreated.
The clinical manifestations, laboratory tests, radiological findings, and treatment of 19 patients with PE between January 2006 and December 2018 in 2 hospitals were retrospectively analyzed.
The mean age of the patients was 38 years, and the ratio of women to men was 2. All patients came from rural areas. Clinical manifestations included cholestatic jaundice, mass, nausea, pain, and swelling. Hemagglutination inhibition test results were positive for all patients. Enzyme-linked immunosorbent assay test results were positive in 17 cases (89.5%). Foci in the pancreas were head in 52.6%, body in 26.3%, body and tail in 15.8%, tail in 5.3%. The size of lesions' diameter ranged from 1 to 12 cm (mean, 6.5 cm). The imaging features of PE included the presence of (a) daughter cysts on abdominal computed tomography (CT) and/or magnetic resonance imaging (MRI); (b) internal cyst wall dissection and ribbon sign on abdominal CT and/or MRI; (c) typical eggshell cyst wall calcification on abdominal CT.
For patients with cystic lesions on CT and/or MRI combined with epidemiological history and positive echinococcosis serology, doctors can correctly diagnose PE earlier. Surgical treatment combined with drugs can reduce the mortality of PE, leading to a better prognosis.
包虫病在流行地区是一个严重的健康问题。近年来，中国这种疾病的发病率一直在上升。由于胰腺包虫病（PE）的影像学特征与囊肿、结核和肿瘤等囊性疾病相似，PE常被误诊和误治。
回顾性分析2006年1月至2018年12月期间2家医院19例PE患者的临床表现、实验室检查、影像学表现及治疗情况。
患者的平均年龄为38岁，男女比例为2。所有患者均来自农村地区。临床表现包括胆汁淤积性黄疸、肿块、恶心、疼痛和肿胀。所有患者血凝抑制试验结果均为阳性。酶联免疫吸附试验结果17例（89.5%）为阳性。胰腺病灶位于头部的占52.6%，位于体部的占26.3%，位于体尾部的占15.8%，位于尾部的占5.3%。病变直径大小为1至12厘米（平均6.5厘米）。PE的影像学特征包括：（a）腹部计算机断层扫描（CT）和/或磁共振成像（MRI）上出现子囊；（b）腹部CT和/或MRI上出现囊内分隔和条带征；（c）腹部CT上出现典型的蛋壳样囊壁钙化。
对于CT和/或MRI上有囊性病变且结合流行病学史及包虫病血清学阳性的患者，医生可更早正确诊断PE。手术治疗联合药物治疗可降低PE的死亡率，预后更佳。
