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肝-肾包虫囊肿:一种罕见疾病表现的诊断与治疗病例报告

Hepato-renal hydatid cyst: a case report of diagnosis and management of an uncommon disease presentation.

作者信息

Boverio Francesca, Di Martino Marcello, Marchioro Giansilvio, Donadon Matteo

机构信息

Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy; Division of General Surgery, Azienda Ospedaliera Universitaria Maggiore della Carità, Novara, Italy.

Division of Urology, Azienda Ospedaliera Universitaria Maggiore della Carità, Novara, Italy.

出版信息

Int J Surg Case Rep. 2025 Aug;133:111597. doi: 10.1016/j.ijscr.2025.111597. Epub 2025 Jul 3.

Abstract

INTRODUCTION

Hydatid cysts, caused by Echinococcus granulosus, are parasitic lesions that primarily affect the liver. However, extrahepatic involvement, including the kidneys, is rare and presents unique diagnostic and therapeutic challenges.

CASE PRESENTATION

We report the case of a 34-year-old male diagnosed with peritoneal, hepatic, and right renal hydatid cysts. Diagnosis was confirmed through diagnostic imaging and serological testing. The patient was initially treated with albendazole to reduce parasitic load. Surgical intervention involved an en-bloc resection, including a right nephrectomy, non-anatomical resection of liver segments S4i-S5-S6-S1pc, and complete excision of a large central peritoneal cyst.

DISCUSSION

Management of complex hydatid disease requires a multidisciplinary approach, integrating medical and surgical strategies to minimize recurrence and complications. Albendazole therapy plays a crucial role in preoperative preparation and reducing the risk of disease dissemination. Radical surgical excision remains the cornerstone of treatment, particularly in cases with multi-organ involvement.

CONCLUSION

This case highlights the necessity of individualized, multidisciplinary management for extensive hydatid disease. Combining medical therapy with tailored surgical approaches ensures optimal patient outcomes. The patient's recovery was uneventful, with no recurrence observed at the 12-month follow-up.

摘要

引言

由细粒棘球绦虫引起的包虫囊肿是主要累及肝脏的寄生虫性病变。然而,包括肾脏在内的肝外受累情况罕见,且带来独特的诊断和治疗挑战。

病例报告

我们报告一例34岁男性,诊断为腹膜、肝脏及右肾包虫囊肿。通过诊断性影像学检查和血清学检测确诊。患者最初接受阿苯达唑治疗以减轻寄生虫负荷。手术干预包括整块切除,即右肾切除术、肝S4i-S5-S6-S1pc段非解剖性切除以及完整切除一个巨大的中央腹膜囊肿。

讨论

复杂包虫病的管理需要多学科方法,整合药物和手术策略以尽量减少复发和并发症。阿苯达唑治疗在术前准备及降低疾病播散风险方面发挥关键作用。根治性手术切除仍是治疗的基石,尤其是在多器官受累的病例中。

结论

本病例凸显了对广泛包虫病进行个体化多学科管理的必要性。将药物治疗与定制的手术方法相结合可确保患者获得最佳预后。患者恢复顺利,12个月随访时未见复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4830/12275149/7acc0ffeb0dd/gr1.jpg

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