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眼眶包虫囊肿,小儿眼球突出的罕见病因:一例报告

Orbital Hydatid Cyst, A rare cause of exophthalmos in paediatric population: A case report.

作者信息

Tahir Asna, Humayun Jawad, Anam Ansa

机构信息

Asna Tahir, Resident Ophthalmologist Department of Ophthalmology, MTI/ Khyber Teaching Hospital, Peshawar, Pakistan.

Jawad Humayun, FCPS Ophthalmology Department of Ophthalmology, MTI/ Khyber Teaching Hospital, Peshawar, Pakistan.

出版信息

Pak J Med Sci. 2025 May;41(5):1549-1551. doi: 10.12669/pjms.41.5.11063.

Abstract

BACKGROUND

Hydatid cyst is a parasitic infection caused by a tapeworm Echinococcus granulosus, mainly involving the liver and lungs with orbital involvement being very rare but when involved can result in unilateral proptosis leading to vision loss in chronic cases. Here, we present a rare case of unilateral orbital hydatid cyst in young male patient of pediatric age group which was successfully treated.

CASE REPORT

A four years old male patient presented with history of trauma and unilateral painless temporal proptosis with dystopia of right eye for two months. On ocular examination, his visual acuity in the right eye was 6/60 and in the left eye it was 6/6. In his right eye there was a positive Relative Afferent Pupillary Defect. On fundus examination, the optic disc was swollen in right eye. The dystopia was 10 mm each, laterally and inferiorly, there was also resistance to retropulsion. In the right eye extraocular movements were restricted in all gazes, a soft tender mass was palpable superior-medially and mild lagophthalmos was also present. Magnetic resonance imaging findings led to the diagnosis of orbital hydatid cyst being the cause of proptosis. Surgical removal of the cyst through superior orbitotomy was performed and its contents were aspirated under general anesthesia. The diagnosis of orbital hydatid cyst was confirmed by histopathological reports of the cyst walls and the aspirated fluid.

CONCLUSION

Orbital hydatid cyst is a very rare occurrence and should be considered a differential diagnosis of proptosis in pediatric population. Surgical removal of the cyst is the main treatment option followed by oral Albendazole for three months.

摘要

背景

包虫囊肿是由细粒棘球绦虫引起的一种寄生虫感染,主要累及肝脏和肺,眼眶受累非常罕见,但一旦受累,可导致单侧眼球突出,在慢性病例中可导致视力丧失。在此,我们报告一例小儿年龄组年轻男性患者单侧眼眶包虫囊肿的罕见病例,该病例已成功治疗。

病例报告

一名4岁男性患者,有外伤史,单侧无痛性颞侧眼球突出伴右眼异位两个月。眼部检查时,其右眼视力为6/60,左眼视力为6/6。右眼存在阳性相对性传入瞳孔障碍。眼底检查发现右眼视盘肿胀。眼球异位分别为外侧和下方各10mm,眼球回纳也有阻力。右眼各注视方向的眼球运动均受限,可在上内侧触及一个柔软压痛的肿块,还存在轻度眼睑闭合不全。磁共振成像结果诊断为眼眶包虫囊肿是眼球突出的原因。通过眶上开眶术对囊肿进行手术切除,并在全身麻醉下抽吸其内容物。囊肿壁和抽吸液的组织病理学报告证实了眼眶包虫囊肿的诊断。

结论

眼眶包虫囊肿非常罕见,在小儿人群中应被视为眼球突出的鉴别诊断之一。手术切除囊肿是主要的治疗选择,术后口服阿苯达唑三个月。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71b4/12130941/dae9ec074b37/PJMS-41-1549-g001.jpg

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