Faculty of Medicine, Lebanese University, Beirut, Lebanon.
Medical Intern, Lebanese University, Beirut, Lebanon.
J Med Case Rep. 2024 Aug 30;18(1):399. doi: 10.1186/s13256-024-04733-7.
Hydatid disease, also known as echinococcosis, is a zoonotic parasitic infection caused by the larvae of the Echinococcus tapeworm. It is endemic in various regions worldwide, particularly in rural areas of countries in southern South America, Central Asia, China, parts of Africa, the Mediterranean, and parts of the Middle East. The disease primarily affects the liver (60-70% of cases) and the lungs (10-25% of cases), but it can involve any organ, including the brain, bones, and rarely the pelvic region, as seen in our case report. Hydatid disease typically follows an asymptomatic course in the early stages of the primary infection and may remain so potentially for years or even permanently. If symptoms occur, they depend on various factors, such as the number, size, and location among other factors. Typically, hydatid disease presents with nonspecific symptoms. Common symptoms include abdominal pain, hepatomegaly, as well as anaphylaxis in case of cyst rupture. Extrahepatic intra-abdominal isolated hydatic cyst is a rare finding (6-11%).
In our case, a 70 year-old Asian white male presented with right thigh pain radiating to the lower leg, which is an atypical presentation for an extrahepatic intraabdominal hydatid cyst. Primary intraabdominal hydatid cysts involving the pelvic region are relatively rare, and such cases pose diagnostic and management challenges.
This case report underscores the challenges in diagnosing and managing extrahepatic intraabdominal hydatid cysts, particularly in atypical presentations. A combination of clinical evaluation, serological studies, and imaging techniques facilitates accurate diagnosis.
包虫病又称棘球蚴病,是一种由细粒棘球绦虫幼虫引起的人畜共患寄生虫感染。它在世界范围内的各个地区流行,特别是在南美洲南部、中亚、中国、非洲部分地区、地中海和中东部分地区的农村地区。这种疾病主要影响肝脏(60-70%的病例)和肺部(10-25%的病例),但也可能涉及任何器官,包括大脑、骨骼,在我们的病例报告中罕见情况下还会涉及骨盆区域。包虫病在初次感染的早期阶段通常无症状,可能潜在地持续数年甚至永久无症状。如果出现症状,则取决于多种因素,例如数量、大小和位置等。通常,包虫病表现为非特异性症状。常见症状包括腹痛、肝肿大,以及囊肿破裂时的过敏反应。肝外腹腔内孤立性包虫囊肿是一种罕见发现(6-11%)。
在我们的病例中,一名 70 岁的亚洲白人男性出现右腿疼痛放射至小腿,这是肝外腹腔内包虫囊肿的非典型表现。累及骨盆区域的原发性腹腔内包虫囊肿相对罕见,此类病例存在诊断和管理挑战。
本病例报告强调了诊断和管理肝外腹腔内包虫囊肿的挑战,特别是在非典型表现时。临床评估、血清学研究和影像学技术的结合有助于准确诊断。