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原发性胰腺包虫囊肿:一例报告并文献复习

Primary pancreatic hydatid cyst: a case report and literature review.

作者信息

Wu Yilei, Gong Jun, Xiong Wei, Yu Xiaojiong, Lu Xiangyu

机构信息

Department of Medical Records Statistics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, Sichuan, China.

The Second Department of Hepatobiliary Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, Sichuan, China.

出版信息

BMC Gastroenterol. 2021 Apr 13;21(1):164. doi: 10.1186/s12876-021-01753-1.

Abstract

BACKGROUND

Hydatid cysts are parasitic zoonoses that often occur in the liver. Pancreatic hydatid cysts are very rare and are usually misdiagnosed as pancreatic cystadenomas. At present, surgical resection combined with albendazole administration is the standard treatment for pancreatic hydatid cysts. However, making accurate preoperative diagnoses and avoiding intraoperative cystic rupture are challenges for surgeons.

CASE PRESENTATION

A 28-year-old woman from the pastoral area presented to the surgical office complaining of abdominal pain and new-onset jaundice that began 9 days earlier. An enhanced computed tomography scan demonstrated a 6.0 × 5.3 cm pancreatic head cystic mass that compressed the common bile duct and induced choledochectasia. The preoperative diagnosis was pancreatic head cystadenoma, and laparotomic pancreaticoduodenectomy was initiated successfully. The intra- and postoperative diagnosis was pancreatic hydatid cyst. The patient was discharged uneventfully 7 days after the operation. A 1-year course of albendazole (15 mg/kg/day) was admitted.

CONCLUSION

Pancreatic hydatid cysts are rare and often misdiagnosed as other types of cysts. History of living in an area in which the causative organism is endemic and positive anti-echinococcus IgG antibody status could help with the diagnosis. Radical resection combined with oral albendazole administration is the standard treatment for pancreatic hydatid cysts. Avoiding perioperative cystic rupture and abdominal echinococcosis implantation metastasis is crucial for the success of the operation.

摘要

背景

包虫囊肿是一种常见于肝脏的寄生虫人畜共患病。胰腺包虫囊肿非常罕见,通常被误诊为胰腺囊腺瘤。目前,手术切除联合阿苯达唑给药是胰腺包虫囊肿的标准治疗方法。然而,准确的术前诊断和避免术中囊肿破裂对外科医生来说是一项挑战。

病例介绍

一名来自牧区的28岁女性因9天前开始出现腹痛和新发黄疸就诊于外科门诊。增强计算机断层扫描显示胰头有一个6.0×5.3厘米的囊性肿块,压迫胆总管并导致胆总管扩张。术前诊断为胰头囊腺瘤,成功实施了剖腹胰十二指肠切除术。术中及术后诊断为胰腺包虫囊肿。患者术后7天顺利出院。接受了为期1年的阿苯达唑(15毫克/千克/天)治疗。

结论

胰腺包虫囊肿罕见,常被误诊为其他类型的囊肿。有在致病生物体流行地区居住史以及抗棘球绦虫IgG抗体状态呈阳性有助于诊断。根治性切除联合口服阿苯达唑给药是胰腺包虫囊肿的标准治疗方法。避免围手术期囊肿破裂和腹部棘球蚴病种植转移对手术成功至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cea3/8045313/7547c4e28c01/12876_2021_1753_Fig1_HTML.jpg

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