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同期肺脾包虫病的单阶段手术治疗:一例罕见病例报告

Single-stage surgical management of simultaneous pulmonary and splenic hydatidosis: A rare case report.

作者信息

Messaoudi Houssem, Bessrour Habib, Lajmi Mokhles, Ragmoun Wafa, Mejri Islam, Hachicha Saber

机构信息

Department of Cardiac and Thoracic Surgery, The Military Hospital of Instruction of Tunis, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia.

Department of Cardiac and Thoracic Surgery, The Military Hospital of Instruction of Tunis, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia.

出版信息

Int J Surg Case Rep. 2024 Dec;125:110580. doi: 10.1016/j.ijscr.2024.110580. Epub 2024 Nov 10.

Abstract

INTRODUCTION

hydatid disease, caused by Echinococcus granulosus, primarily affects the liver and lungs, with splenic involvement being exceedingly rare, occurring in only 0.5 % of cases. This case report highlights a 17-year-old male presenting with a complicated hydatid cyst in the lung, along with an incidental splenic cyst, emphasizing the importance of single-stage surgery in treating multi-organ hydatid disease.

CASE PRESENTATION

a 17-year-old male presented with a three-month history of left-sided chest pain and a dry cough. Imaging revealed a complicated hydatid cyst in the left lung and an incidental splenic cyst. Serological tests confirmed the presence of anti-hydatid antibodies. A single-stage surgical approach was performed via a transthoracic route, involving cystectomy and pericystectomy for the pulmonary cyst, followed by removal of the splenic cyst. The postoperative recovery was uneventful, and the patient was discharged on the fifth day with a six-month course of oral albendazole.

DISCUSSION

hydatid disease is a significant public health issue, with simultaneous pulmonary and splenic involvement being rare. Surgical intervention remains the cornerstone of treatment for pulmonary hydatid disease, with medical therapy used as an adjunct. In this case, a single-stage surgery was chosen due to its advantages, such as reduced anesthesia, shorter hospital stays, and faster recovery.

CONCLUSION

single-stage surgery provides an effective and efficient option for managing multi-organ hydatid disease. This case highlights its feasibility and benefits, particularly in young patients from endemic regions.

摘要

引言

由细粒棘球绦虫引起的包虫病主要影响肝脏和肺部,脾脏受累极为罕见,仅在0.5%的病例中出现。本病例报告强调了一名17岁男性,其肺部有一个复杂的包虫囊肿,同时伴有一个偶然发现的脾囊肿,强调了一期手术治疗多器官包虫病的重要性。

病例介绍

一名17岁男性,有三个月的左侧胸痛和干咳病史。影像学检查显示左肺有一个复杂的包虫囊肿以及一个偶然发现的脾囊肿。血清学检查证实存在抗包虫抗体。通过经胸途径进行一期手术,包括对肺囊肿进行囊肿切除术和囊肿周围切除术,随后切除脾囊肿。术后恢复顺利,患者在第五天出院,并接受为期六个月的口服阿苯达唑治疗。

讨论

包虫病是一个重大的公共卫生问题,肺部和脾脏同时受累的情况很少见。手术干预仍然是治疗肺包虫病的基石,药物治疗作为辅助手段。在本病例中,选择一期手术是因为其具有减少麻醉、缩短住院时间和更快恢复等优点。

结论

一期手术为治疗多器官包虫病提供了一种有效且高效的选择。本病例突出了其可行性和益处,特别是对于来自流行地区的年轻患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0fd/11609383/f57876c1c8ca/gr1.jpg

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