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腹膜后包虫囊肿的诊断难题:病例报告并文献复习

Retroperitoneal hydatid cyst challenging the diagnosis: Case report with review of literature.

作者信息

Yadav Sushil Kumar, Ruchal Anish, Gaurav Bishal, Bhattarai Bhawesh, Khatiwada Prajwal, Shrestha Aiska

机构信息

Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, 44600 Kathmandu, Nepal.

Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, 44600 Kathmandu, Nepal.

出版信息

Int J Surg Case Rep. 2024 Jan;114:109106. doi: 10.1016/j.ijscr.2023.109106. Epub 2023 Dec 13.

Abstract

INTRODUCTION

Hydatid cyst is a zoonotic disease caused by a tapeworm, Echinococcus granulosus. A retroperitoneal hydatid cyst is extremely rare and its diagnosis can be challenging, particularly in the early stage as it can mimic several regional pathologies like pancreatic pseudocyst, pancreatic neoplasm, and other retroperitoneal cystic lesions.

PRESENTATION OF CASE

We report a rare case of 39-year-old Nepalese male with a left retroperitoneal hydatid cyst who presented with pain and feeling of mass in the left flank region for 6 months. Diagnosis was made by abdominal computed tomography and magnetic resonance imaging and management was done by partial cystectomy.

DISCUSSION

Retroperitoneal hydatid cysts can present with chronic pain, mass, and symptoms resulting from the mass effect which varies according to the different retroperitoneal locations. Diagnosis of the retroperitoneal cyst can be challenging clinically and radiologically in its early stages. Even in the late stage, ultrasonography may not suffice and additional imaging techniques such as computed tomography or magnetic resonance imaging are required for the diagnosis.

CONCLUSION

In endemic areas, hydatid cyst should be considered while dealing with a retroperitoneal swelling for early diagnosis and prevention of rupture. With a high level of clinical suspicion and radiological findings, retroperitoneal hydatid cyst can be diagnosed and surgery is the principal method of treatment.

摘要

引言

包虫囊肿是一种由细粒棘球绦虫引起的人畜共患病。腹膜后包虫囊肿极为罕见,其诊断可能具有挑战性,尤其是在早期,因为它可能类似于多种局部病变,如胰腺假性囊肿、胰腺肿瘤和其他腹膜后囊性病变。

病例介绍

我们报告了一例罕见的39岁尼泊尔男性患者,患有左侧腹膜后包虫囊肿,其左侧胁腹区域疼痛并伴有肿块感达6个月。通过腹部计算机断层扫描和磁共振成像进行诊断,并通过部分囊肿切除术进行治疗。

讨论

腹膜后包虫囊肿可表现为慢性疼痛、肿块以及因肿块效应引起的症状,这些症状因腹膜后不同位置而异。腹膜后囊肿在早期的临床和放射学诊断可能具有挑战性。即使在晚期,超声检查可能也不够,诊断需要额外的成像技术,如计算机断层扫描或磁共振成像。

结论

在流行地区,处理腹膜后肿胀时应考虑包虫囊肿,以便早期诊断和预防破裂。凭借高度的临床怀疑和放射学检查结果,可以诊断腹膜后包虫囊肿,手术是主要的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ab3/10800713/719f1d8f1401/gr1.jpg

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