Aurousseau R, Martinon F
J Chir (Paris). 1977;114(3):167-74.
The authors report the case of a large pelvic tumour compressing the bladder, the ureters and the recto-sigmoid junction. Its sudden rupture into the peritoneum led to an emergency operation and the discovery of a hydatid cyst ruptured into the pouch of Douglas and a hepatic cyst. The most frequent presentation of peritoneal echinococcosis, peritoneal cysts are metastases from a hepatic or splenic cyst which has ruptured into the peritoneum. They are usually multiple. Single pelvic lesions are rare, their hydatid nature is in the absence of a past history of hydatid disease difficult to suspect before operation. The object of the latter is to treat in one stage the primary cyst and its peritoneal metastases. The narrow vascular connections of the pelvic cysts render cystectomy dangerous and make one prefer removal of the germinal membrane followed by marsupialisation or drainage of the remaining cavity. In the long term, the frequency of peritoneal recurrences makes prolonged supervision necessary.
作者报告了一例巨大盆腔肿瘤压迫膀胱、输尿管及直肠乙状结肠交界处的病例。该肿瘤突然破裂进入腹膜,导致急诊手术,术中发现一个破裂进入Douglas窝的包虫囊肿和一个肝囊肿。腹膜包虫病最常见的表现形式是腹膜囊肿,它们是肝或脾囊肿破裂进入腹膜后的转移灶。通常为多发。单个盆腔病变罕见,在没有包虫病既往史的情况下,其包虫性质在术前很难怀疑。手术目的是一期治疗原发性囊肿及其腹膜转移灶。盆腔囊肿的血管连接狭窄,使得囊肿切除术具有危险性,因而更倾向于切除生发膜,随后对剩余腔隙行袋形缝合术或引流术。从长远来看,由于腹膜复发的频率较高,因此需要长期随访。