Kbir Ghassen Hamdi, Messaoudi Sohaib, Selmi Marwen, Maatouk Mohamed, Bouzidi Mohamed Tahar, Ennaceur Farouk, Ben Moussa Mounir
A21 Surgery Department, Charles Nicolle Hospital, Research laboratory LR12ES01, Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
IDCases. 2022 Feb 18;27:e01455. doi: 10.1016/j.idcr.2022.e01455. eCollection 2022.
Echinococcosis is endemic in Mediterranean countries. Liver then lungs are the most affected organs. Gallbladder hydatid cyst is an exceptional localization. A 64-year-old patient was referred to our surgical outpatient department by his physician for suspicion of liver hydatid cyst based on right upper quadrant abdominal pain, associated with nausea. Physical examination showed mild tenderness of the right upper quadrant of the abdomen. A computed tomography abdominal scan showed a multivesicular cystic lesion of the segment IV measuring 9.5 × 7.5 × 13 cm with exophytic component abutting the gallbladder. The patient underwent right subcostal laparotomy. The exploration has found that the hydatid cyst is developed from the fundus of the gallbladder, without any connections or fistulas to nearby organs. A cholecystectomy was performed. Histopathological examination confirmed the diagnosis of gallbladder echinococcosis. Primary gallbladder hydatid cysts (PGHC) is an extremely rare condition, occurring in less than 0.4% of echinococcosis localizations. After literature research of case reports, only twenty-three such cases, including our case, have been reported in English literature. Due to its uncommon nature, radiologists rarely consider a PHGB as the first diagnosis. Preoperative diagnosis of hydatid cyst was possible only in 50% of cases. Therefore, a careful attention is necessary to assist in making the diagnosis preoperatively, leading to the appropriate treatment.
包虫病在地中海国家呈地方性流行。肝脏和肺是最常受累的器官。胆囊包虫囊肿是一种罕见的发病部位。一名64岁患者因右上腹腹痛伴恶心，被其医生转诊至我们的外科门诊，怀疑患有肝包虫囊肿。体格检查发现右上腹轻度压痛。腹部计算机断层扫描显示IV段有一个多房性囊性病变，大小为9.5×7.5×13厘米，有外生性成分紧邻胆囊。患者接受了右肋缘下剖腹手术。探查发现包虫囊肿起源于胆囊底部，与附近器官无任何连接或瘘管。进行了胆囊切除术。组织病理学检查证实了胆囊包虫病的诊断。原发性胆囊包虫囊肿（PGHC）是一种极为罕见的疾病，在包虫病发病部位中所占比例不到0.4%。在对病例报告进行文献研究后，英文文献中仅报道了包括我们的病例在内的23例此类病例。由于其不常见的性质，放射科医生很少将原发性胆囊包虫囊肿作为首要诊断。术前仅50%的病例能够诊断出包虫囊肿。因此，术前需要仔细关注以协助做出诊断，从而进行适当的治疗。
