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钝性腹部创伤后播散性腹部囊性棘球蚴病:一例报告

Disseminated Abdominal Cystic Echinococcosis After Blunt Abdominal Trauma: A Case Report.

作者信息

Baimakhanov Bolatbek Bimendeevich, Harandi Majid Fasihi, Kaniyev Shokan Akhmetbekovich, Ismailova Gulziya Nurtazayevna, Nurlanbayev Erik Kumarbekovich, Sadykov Chingiz Takhirovich, Muratkyzy Gulziba

机构信息

Chairman of the Board of JSC Syzganov National Scientific Center of Surgery, Almaty, Kazakhstan.

Academician of the National Academy of Sciences, Almaty, Kazakhstan.

出版信息

Iran J Med Sci. 2024 Nov 1;49(11):741-747. doi: 10.30476/ijms.2024.102545.3553. eCollection 2024 Nov.

Abstract

Rupture of a hydatid cyst can lead to the development of a disseminated form of intra-abdominal cystic echinococcosis if not diagnosed and treated promptly. Anaphylactic shock is a definite indication of cyst rupture. The presented clinical case was a young athlete with a disseminated form of cystic echinococcosis, which was investigated in 2023 at the Syzganov National Scientific Center for Surgery of Kazakhstan. The disease developed gradually following a sports injury to the abdomen during sports training and was accompanied by blurred signs of anaphylactic shock. In the next 2 years, echinococcosis of the abdominal cavity was asymptomatic. The clinical manifestation of cystic echinococcosis developed gradually over the last 10-12 weeks, in the form of dull, painful abdominal pain, malaise, weakness, sweating, nausea, poor appetite, and weight loss. Subacute manifestations of the disease resembled those of acute appendicitis. A diagnostic laparotomy revealed an abundance of cystic formations in the abdominal cavity, necessitating a differential diagnosis between a disseminated form of abdominal tuberculosis with damage to the mesenteric lymph nodes. However, instrumental verification of the parasite, together with the morphological exclusion of the extrapulmonary form of tuberculosis, made it possible to establish a disseminated form of cystic echinococcosis. The patient underwent a cystectomy, was discharged in satisfactory condition, and was informed about the possibility of disease recurrence. In conclusion, in hyperendemic zones, it is recommended to carry out immunological testing for echinococcosis on all abdominal sports injuries, independent of the presence of anaphylactic shock symptoms.

摘要

如果未及时诊断和治疗,包虫囊肿破裂可导致腹腔播散性囊型棘球蚴病的发生。过敏性休克是囊肿破裂的明确指征。本文介绍的临床病例是一名患有播散性囊型棘球蚴病的年轻运动员,于2023年在哈萨克斯坦的Syzganov国家外科科学中心接受检查。该疾病在运动训练中腹部受到运动损伤后逐渐发展,并伴有过敏性休克的模糊症状。在接下来的2年里,腹腔棘球蚴病无症状。囊型棘球蚴病的临床表现是在过去10 - 12周内逐渐出现的,表现为腹部隐痛、不适、乏力、出汗、恶心、食欲不振和体重减轻。该疾病的亚急性表现类似于急性阑尾炎。诊断性剖腹手术显示腹腔内有大量囊性肿物,需要与伴有肠系膜淋巴结损害的播散性腹腔结核进行鉴别诊断。然而,对寄生虫的仪器检测以及对肺外结核形态学的排除,使得确诊为播散性囊型棘球蚴病成为可能。患者接受了囊肿切除术,出院时情况良好,并被告知疾病复发的可能性。总之,在高流行区,建议对所有腹部运动损伤进行棘球蚴病的免疫学检测,无论是否存在过敏性休克症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fd9/11645415/5cc25a7ab04a/IJMS-49-741-g001.jpg

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