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病例报告:巨大纵隔-腹部包虫囊肿经拉雷氏裂孔延伸:一例罕见病例报告。

Case Report: Large mediastino-abdominal hydatid cyst extending through the Larrey's hiatus: A rare case report.

作者信息

Messaoudi Houssem, Bessrour Habib, Lajmi Mokhles, Raghmoun Wafa, Ferjaoui Wael, Khalifa Mohamed Bechir, Hachicha Saber

机构信息

cardio-thoracic department, Military Hospital of Instruction of Tunis, Tunis, Tunis, Tunisia.

General surgery department, Military Hospital of Instruction of Tunis, Tunis, Tunis, Tunisia.

出版信息

F1000Res. 2024 Dec 5;13:1484. doi: 10.12688/f1000research.159463.1. eCollection 2024.

Abstract

BACKGROUND

The extension of hydatid liver cysts into the mediastinum through diaphragmatic hiatus is extremely rare. In this report, we describe a rare case of a hydatid liver cyst with mediastinal extension through Larrey's hiatus, emphasizing the surgical strategy for successful treatment.In this report, we present the first documented case of a hydatid liver cyst extending into the mediastinum through Larrey's hiatus.

CASE PRESENTATION

We report the case of a 65-year-old male who presented with right-upper-quadrant and left-sided chest pain evolving for two months. Physical examination showed dullnes in the epigastric region. A thoraco-abdominal CT scan, revealed a 13 cm mediastino-abdominal hydatid cyst, centered on the left liver lobe with extension into the mediastinum through the Larray's diaphragmatic hiatus. The patient underwent surgical management. Both thoracic and visceral surgeons were involved. The surgical management involved both thoracic and visceral surgeons. A Makuuchi incision allowed resection of the hydatid liver cyst. The mediastinal portion of the cyst, resting on the pericardium was aspirated through Larrey's hiatus, followed by irrigation with a scolicidal solution. The postoperative course was uneventful.

CONCLUSION

Transmediastinal hydatid liver cysts are rare and should be operated on in close collaboration between visceral and thoracic surgeons to prevent complications.

摘要

背景

肝包虫囊肿经膈肌裂孔延伸至纵隔极为罕见。在本报告中,我们描述了一例罕见的经拉雷氏裂孔(Larrey's hiatus)纵隔延伸的肝包虫囊肿病例,强调成功治疗的手术策略。在本报告中,我们呈现了首例经拉雷氏裂孔纵隔延伸的肝包虫囊肿的文献记载病例。

病例介绍

我们报告了一例65岁男性患者,右上腹和左侧胸痛持续两个月。体格检查显示上腹部叩诊浊音。胸腹CT扫描显示一个13厘米的纵隔-腹部包虫囊肿,以左肝叶为中心,经拉雷氏膈肌裂孔延伸至纵隔。患者接受了手术治疗。胸外科和普外科医生均参与其中。手术治疗涉及胸外科和普外科医生。经马库uchi切口切除肝包虫囊肿。通过拉雷氏裂孔抽吸位于心包上的囊肿纵隔部分,随后用杀头节剂溶液冲洗。术后病程顺利。

结论

经纵隔肝包虫囊肿罕见,应在内科和胸外科医生密切协作下进行手术,以预防并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e68/11803381/c1cadfb53148/f1000research-13-175188-g0000.jpg

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