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伴有肝胸膜瘘的肺包虫病:一例报告。

Pulmonary hydatidosis with hepatopleural fistula: A case report.

作者信息

Wampembe Elizabeth Ubald, Lodhia Jay, Fabrice Lele Mutombo, Elisante Joseph, Dohho Anna, Chilonga Salum Kondo

机构信息

General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania.

General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Surgery, Heal Africa Hospital, Goma, Congo.

出版信息

Int J Surg Case Rep. 2024 Mar;116:109353. doi: 10.1016/j.ijscr.2024.109353. Epub 2024 Feb 7.

Abstract

INTRODUCTION AND IMPORTANCE

Cystic echinococcosis (CE) is a chronic illness caused by the tapeworm Echinococcus granulosus. It is classified as a neglected disease and is a priority according to the World Health Organization. CE is prevalent in populations engaged in specific livestock practices and is associated with poor living conditions.

CASE PRESENTATION

41-year-old female Maasai patient who presented with symptoms of cough, dyspnea, fever, and weight loss. Physical examination and CT scans confirmed the presence of cystic masses in the lungs and liver. The patient underwent a thoracotomy procedure to address complications from a hepato-pleural fistula.

CLINICAL DISCUSSION

Echinococcus is a tropical disease that affects over a million people worldwide annually. It primarily affects communities engaged in animal husbandry and causes the development of hydatid cysts. Diagnosis can be challenging due to prolonged asymptomatic periods. In rare cases, cysts can rupture into the pleura and bronchial tree, causing respiratory symptoms. Surgical treatment involves the systematic evacuation of cysts and visceral cyst excision, with concurrent laparotomy and thoracotomy being the optimum approach.

CONCLUSION

Hydatid cysts remain a significant health problem, particularly when large pleural cysts occur with subphrenic liver cysts. Surgical intervention, specifically a single-stage thoracotomy, is the preferred first-line treatment. This approach allows for both cysts to be addressed in a single procedure, providing effective and efficient treatment to patients.

摘要

引言与重要性

囊型包虫病(CE)是由细粒棘球绦虫引起的一种慢性疾病。它被归类为被忽视的疾病,是世界卫生组织确定的重点疾病。CE在从事特定畜牧活动的人群中流行,且与生活条件差有关。

病例介绍

一名41岁的马赛族女性患者,出现咳嗽、呼吸困难、发热和体重减轻等症状。体格检查和CT扫描证实肺部和肝脏存在囊性肿块。患者接受了开胸手术以处理肝胸膜瘘的并发症。

临床讨论

棘球绦虫病是一种热带疾病,每年影响全球超过100万人。它主要影响从事畜牧业的社区,并导致包虫囊肿的形成。由于无症状期较长,诊断可能具有挑战性。在罕见情况下,囊肿可破裂进入胸膜和支气管树,引起呼吸道症状。手术治疗包括系统性囊肿排空和内脏囊肿切除,同时进行剖腹术和开胸术是最佳方法。

结论

包虫囊肿仍然是一个重大的健康问题,特别是当巨大的胸膜囊肿与膈下肝囊肿同时出现时。手术干预,特别是一期开胸术,是首选的一线治疗方法。这种方法允许在一次手术中处理两个囊肿,为患者提供有效且高效的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8dc/10943639/ed81a64a07ad/gr1.jpg

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