Nagler A, Enat R, Brenner B, Israel O, Argov S
Am J Gastroenterol. 1985 Oct;80(10):819-21.
Two patients presenting with right upper abdominal colicky pain, jaundice, and fever had a hepatobiliary scan using Tc 99m HIDA. The scan was suggestive of acute cholecystitis and a space occupying lesion in the liver. On operation, liver echinococcosis, located in the right lobe rupturing into the biliary ductal system, was found. Intraoperative cholangiography revealed filling defects in the main biliary ducts. Exploration of the common bile duct disclosed daughter cysts and cystic debris. Acute cholecystitis or stones were not found. We conclude that in patients with a clinical picture and HIDA scanning compatible with acute cholecystitis and a space occupying lesion in the liver, the diagnosis of hydatid cyst of the liver which has ruptured into the biliary tract should be considered.
两名出现右上腹绞痛、黄疸和发热症状的患者接受了使用锝 99m 二乙基乙酰苯胺亚氨基二乙酸（Tc 99m HIDA）的肝胆扫描。扫描结果提示急性胆囊炎以及肝脏内有占位性病变。手术中发现位于右叶的肝包虫病破裂进入胆管系统。术中胆管造影显示主胆管内有充盈缺损。胆总管探查发现有子囊和囊内碎屑。未发现急性胆囊炎或结石。我们得出结论，对于临床表现和 HIDA 扫描结果与急性胆囊炎及肝脏占位性病变相符的患者，应考虑诊断为已破裂进入胆道的肝包虫囊肿。
