Maghrebi Houcine, Ben Mahmoud Ahmed, Haddad Anis, Cheikhrouhou Sarra, Sebei Amine, Chaker Youssef, Boukriba Seif, Jeribi Bedis, Rebai Wael, Kacem Montasser Jameleddine
Department of General Surgery A, Rabta Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
Department of Parasitology, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
Int J Surg Case Rep. 2020;76:69-72. doi: 10.1016/j.ijscr.2020.09.163. Epub 2020 Sep 28.
Hydatid disease is a global zoonosis. Any organ of the human body can be involved. Single or multiple locations are reported. However, retroperitoneal hydatid cysts are uncommon. Furthermore, parietal complications are rarely reported in literature. Therefore, the management of hydatid cysts ruptured in the abdominal wall remains challenging.
In this case report, we aim to describe our experience in treating a primary retroperitoneal hydatid cyst with rupture into abdominal wall in an 87-year-old woman who presented with a 15-centimeter mass of the right flank. Hydatid serology test was positive. An abdominal CT scan showed a 20-centimeter cystic mass of retroperitoneum extended to the abdominal wall with several septa within and enhanced thick wall. The patient underwent a surgical elective drainage with perioperative antiparasitic chemotherapy. Follow-up showed no recurrence.
Primary retroperitoneal hydatid cyst with parietal complications is scarce and barely described in literature. We performed a review of the recent relevant literature that deals with this subject. None of the hydatid cysts reported in 55 cases was located in retroperitoneum. The top seven countries of origin are located in Mediterranean region except for India. Imaging is compulsory for the diagnosis along with patient's history, physical examination and hydatid serology. The treatment is surgical and must be must be covered by antiparasitic chemotherapy.
Primary retroperitoneal hydatid cyst extended to the abdominal wall remains a rare and challenging diagnosis that must be considered in endemic countries.
包虫病是一种全球性人畜共患病。人体的任何器官都可能受累。有报告称可发生于单个或多个部位。然而，腹膜后包虫囊肿并不常见。此外，文献中很少报道其壁层并发症。因此，处理腹壁破裂的包虫囊肿仍然具有挑战性。
在本病例报告中，我们旨在描述我们治疗一名87岁女性原发性腹膜后包虫囊肿破裂至腹壁的经验，该患者右侧腹部有一个15厘米的肿块。包虫血清学检测呈阳性。腹部CT扫描显示一个20厘米的腹膜后囊性肿块，延伸至腹壁，内部有多个分隔，壁增厚且强化。患者接受了择期手术引流及围手术期抗寄生虫化疗。随访显示无复发。
原发性腹膜后包虫囊肿伴壁层并发症较为罕见，文献中几乎没有描述。我们对近期有关该主题的相关文献进行了综述。55例报告的包虫囊肿中无一例位于腹膜后。除印度外，前七个发病国家位于地中海地区。诊断必须结合患者病史、体格检查、包虫血清学以及影像学检查。治疗方法为手术治疗，且必须辅以抗寄生虫化疗。
原发性腹膜后包虫囊肿延伸至腹壁仍然是一种罕见且具有挑战性的诊断，在流行国家必须予以考虑。
