Köstek Mehmet, Bostancı Özgür, Battal Muharrem, Alkım Hüseyin
Clinic of General Surgery, Şişli Hamidiye Etfal Research and Education Hospital, Health Sciences University, İstanbul, Türkiye.
Clinic of Gastroenterology, Şişli Hamidiye Etfal Research and Education Hospital, Health Sciences University, İstanbul, Türkiye.
Turk J Surg. 2023 Dec 29;39(4):383-386. doi: 10.47717/turkjsurg.2023.4768. eCollection 2023 Dec.
Hydatid disease is a zoonotic parasitic disease which rarely involves pancreas primarily. Diagnosis of pancreatic hydatid cyst is a challenge and operative skills are important to avoid spillage of cyst's content. A 19-year-old male patient was admitted to hospital with recurrent abdominal pain which was on epigastrium and left upper quadrant of abdomen. Pain was not associated with nausea, vomiting or fever. An abdominal computed tomography (CT) scan was ordered. As a result of abdominal CT scan, there was a cystic area in tail of pancreas with a diameter of 5.6 cm which includes septa and there was calcification on borders of the cyst. Possible diagnosis were either pancreatic hydatid disease, pancreatic cyst adenoma or cystadenocarcinoma or pseudocyst of autoimmune pancreatitis. Whole body positron emission tomography (PET-CT) scan showed no other cyst or lesion other than pancreatic cyst. Hydatid disease indirect hemagglutination test has been studied and it was positive. Imaging studies and laboratory results were suggested hydatid disease and laparoscopic distal pancreatectomy has been applied. Primary pancreatic hydatid disease should be in differential diagnosis when newly appearing pancreatic cyst has been diagnosed, especially in endemic areas. Appropriate surgical technique has to be applied to avoid dissemination of cyst's content.
包虫病是一种人畜共患的寄生虫病，很少以胰腺为主要受累部位。胰腺包虫囊肿的诊断具有挑战性，手术技巧对于避免囊肿内容物溢出很重要。一名19岁男性患者因上腹部和左上腹反复腹痛入院。疼痛与恶心、呕吐或发热无关。遂进行了腹部计算机断层扫描（CT）。腹部CT扫描结果显示，胰腺尾部有一个直径5.6厘米的囊性区域，内有分隔，囊肿边界有钙化。可能的诊断为胰腺包虫病、胰腺囊腺瘤或囊腺癌或自身免疫性胰腺炎假性囊肿。全身正电子发射断层扫描（PET-CT）显示除胰腺囊肿外无其他囊肿或病变。已进行包虫病间接血凝试验，结果呈阳性。影像学检查和实验室结果提示为包虫病，并实施了腹腔镜远端胰腺切除术。当诊断出新出现的胰腺囊肿时，尤其是在流行地区，原发性胰腺包虫病应列入鉴别诊断。必须应用适当的手术技术以避免囊肿内容物播散。
