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肺包虫肺栓塞:病例报告及文献复习。

Hydatid Pulmonary Embolism: A Case Report and Literature Review.

机构信息

Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland).

Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland).

出版信息

Am J Case Rep. 2021 Nov 30;22:e934157. doi: 10.12659/AJCR.934157.

Abstract

BACKGROUND Infection with Echinococcus granulosus is endemic in sheep and dogs in Central Asia, including Tibet. In humans, ingested parasites from the gastrointestinal system enter the liver via the portal vein. Rarely, hepatic hydatid cysts can rupture into the portal vein and embolize to the lungs. This report is of a 58-year-old woman with liver cysts and a pulmonary embolism due to hydatid disease. CASE REPORT We present a rare case of a pulmonary embolism caused by a hydatid cyst. A 58-year-old woman from the Tibet Autonomous Region of China was admitted to the hospital with symptoms of chest and back pain and shortness of breath within the previous 6 months. She had a 5-year history of hepatic echinococcosis. During hospitalization, the patient reported having aggravated chest and back pain and she developed a new symptom of hemoptysis. A pulmonary embolism was confirmed by computed tomography pulmonary angiography. After a multidisciplinary consultation, and based on the patient's medical history, clinical manifestations, laboratory test results, and imaging findings, a diagnosis of a pulmonary embolism caused by a hydatid cyst was established. CONCLUSIONS This report shows the importance of imaging findings in diagnosing a non-thrombotic pulmonary embolism due to hepatic hydatid disease. In this case, early and accurate diagnosis resulted in appropriate treatment with multidisciplinary patient management.

摘要

背景

包虫病(棘球蚴病)在包括西藏在内的中亚地区的绵羊和狗中流行。在人类中,从胃肠道摄入的寄生虫通过门静脉进入肝脏。极少数情况下,肝包虫囊肿可破裂进入门静脉并栓塞至肺部。本报告介绍了一例因包虫病导致肝脏囊肿和肺栓塞的 58 岁女性病例。

病例报告

我们报告了一例由包虫囊肿引起的肺栓塞的罕见病例。一位来自中国西藏自治区的 58 岁女性,在过去 6 个月内出现胸痛和呼吸急促的症状。她患有 5 年的肝包虫病。住院期间,患者报告胸痛和背痛加重,并出现新的咯血症状。肺部计算机断层血管造影术(CTPA)证实为肺栓塞。经过多学科会诊,根据患者的病史、临床表现、实验室检查结果和影像学表现,诊断为包虫囊肿引起的肺栓塞。

结论

本报告显示了影像学发现对诊断肝包虫病引起的非血栓性肺栓塞的重要性。在本例中,早期和准确的诊断导致了多学科患者管理的适当治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d540/8646948/804e9498031c/amjcaserep-22-e934157-g001.jpg

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