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肝包虫囊肿导致胆汁性肝硬化和门静脉高压的罕见表现。

An uncommon presentation of hepatic hydatid cyst leading to biliary cirrhosis and portal hypertension.

作者信息

Asadzadeh-Aghdaei Hamid, Moshari Mohammad Reza, Zandi Reza, Karimi Mohammad Ali, Salari Sina, Ketabi Moghadam Pardis

机构信息

Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Gastroenterol Hepatol Bed Bench. 2020 Winter;13(Suppl1):S145-S148.

Abstract

Hydatid disease is an ongoing issue in endemic areas. Hydatid cysts can be seen in any organ but, liver is one of the most common involved organs. Cystobiliary communication as an overwhelming complication of hepatic hydatid cysts can contribute to the obstructive jaundice, cholangitis, sepsis and even biliary cirrhosis if left untreated. The patient we are trying to present is a 61-year-old farmer who presented with obstructive jaundice, multiple common bile duct stones and biliary cirrhosis attributed to a long-lasting untreated hepatic hydatid cyst. Portal hypertension is introduced to be an uncommon presentation of hydatid cyst. Extrinsic compression of the porta hepatis and obstruction of inferior vena cava are amongst major causes of hydatidosis leading up to portal hypertension as reported in the literature. Portal hypertension in the presented case is proposed to emerge from long-lasting cystobiliary communication ending in biliary cirrhosis.

摘要

包虫病在流行地区仍然是一个突出问题。包虫囊肿可见于任何器官,但肝脏是最常受累的器官之一。作为肝包虫囊肿极为严重的并发症,囊肿胆管瘘若不治疗可导致梗阻性黄疸、胆管炎、败血症,甚至胆汁性肝硬化。我们要介绍的这位患者是一名61岁的农民,因长期未治疗的肝包虫囊肿出现了梗阻性黄疸、多发胆总管结石和胆汁性肝硬化。门静脉高压是包虫囊肿罕见的表现形式。如文献报道,肝门部的外部压迫和下腔静脉梗阻是导致包虫病进而引发门静脉高压的主要原因。该病例中的门静脉高压被认为是由长期的囊肿胆管瘘最终导致胆汁性肝硬化引起的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9485/7881412/219aad32770b/GHFBB-13-S145-g001.jpg

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