First Successful Puncture, Aspiration, Injection, and Re-Aspiration of Hydatid Cyst in the Liver Presenting with Anaphylactic Shock in Korea

박경화,정숙인,신종희,장희창 연세대학교의과대학 2009 Yonsei medical journal Vol.50 No.5

Hydatid disease is a parasitic infestation caused by the larval form of Echinocococcus. In human, the most commonly affected organs are liver and lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. In Korea, hydatid disease is rare and surgically treated cases have been reported in the Korean literature. However, it is expected to confront this disease sooner or later, because of recent increase in traveling to the endemic area and industrial workers originating from those areas. With this trend, we experienced a case of hydatid cyst of the liver in a male patient from Uzbekistan. This patient was presented with anaphylactic shock combined with hydatid cyst. We successfully treated using ultrasound-guided transhepatic percutaneous drainage [termed puncture, aspiration, injection, and re-aspiration (PAIR)] of the hydatid cyst and concomitant albendazole instead of surgery. In this clinical case report, we describe all the course of the patient and recommend the PAIR as a first choice method for treatment of hepatic hydatid cyst. Hydatid disease is a parasitic infestation caused by the larval form of Echinocococcus. In human, the most commonly affected organs are liver and lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. In Korea, hydatid disease is rare and surgically treated cases have been reported in the Korean literature. However, it is expected to confront this disease sooner or later, because of recent increase in traveling to the endemic area and industrial workers originating from those areas. With this trend, we experienced a case of hydatid cyst of the liver in a male patient from Uzbekistan. This patient was presented with anaphylactic shock combined with hydatid cyst. We successfully treated using ultrasound-guided transhepatic percutaneous drainage [termed puncture, aspiration, injection, and re-aspiration (PAIR)] of the hydatid cyst and concomitant albendazole instead of surgery. In this clinical case report, we describe all the course of the patient and recommend the PAIR as a first choice method for treatment of hepatic hydatid cyst.

간내 원발 낭종 파열에 의해 발생한 다발 복강 내 포충낭종 1예

강명진 ( Myung Jin Kang ),이석호 ( Suck Ho Lee ),김성준 ( Sung Joon Kim ),최용호 ( Young Ho Chei ),박정훈 ( Jeong Hoon Park ),박도현 ( Do Hyun Park ),박상흠 ( Sang Heum Park ),김선주 ( Sun Joo Kim ) 대한소화기학회 2007 대한소화기학회지 Vol.50 No.3

Hydatid disease is a parasitic infestation caused by the larval form of the cestode worms Echinococcus. In humans, the most commonly affected organs are liver and lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. The incidence of hydatid disease is high in the Middle East, Australia, East and South Africa and Central Europe. In Korea, hydatid disease is rare and has been reported in a few cases. We experienced a case of multiple intraperitoneal cysts from ruptured hepatic hydatid cysts in a 35-year old man. His complaint was palpable abdominal mass and discomfort. Abdominal ultrasound and CT scan revealed multiple hepatic and intraperitoneal cysts. The surgical findings showed multiple cysts and daughter cysts. The pathologic finding of resected cyst was the characteristic pattern of outer thick laminated membrane and inner thin germinal layer. Albendazole was administrated for prophylatic purpose. (Korean J Gastroenterol 2007;50:203-206)

Intact and Perforated Pulmonary Hydatid Cyst: A Comparative Study from Damascus, Syria

Mohammad Almess,Basel Ahmad,Bassam Darwish 대한흉부외과학회 2020 Journal of Chest Surgery (J Chest Surg) Vol.53 No.6

Background: Hydatidosis is a major health problem around the world, especially in the Mediterranean region. Cysts can break open or develop secondary bacterial infections, alter- ing the clinical presentation. Methods: Patients who underwent hydatid cyst surgery at Al-Mouassat University Hos- pital in Damascus, Syria between January 2006 and December 2017 were evaluated. Cases involving isolated hepatic cysts were excluded. The patients were divided into those with perforated hydatid cysts (group 1) and those with intact hydatid cysts (group 2). Results: This study included 224 cases: 113 in group 1 (50.4%) and 111 in group 2 (49.6%). The median chest tube duration, hospitalization time, and postoperative complication rate were higher in group 1 than in group 2 (p=0.003, p=0.002, and p=0.006, respectively). In both groups, the most common symptom was cough (present in 178 patients in total [79.5%]), while chest pain (121 patients [54%]) and dyspnea (113 patients [50.4%]) were also common. Cough, hemoptysis, fever, and expectoration of cystic contents were signifi- cantly more frequent in group 1 than in group 2 (p<0.001). Conclusion: The early discovery and treatment of intact pulmonary hydatid cysts re- duced the hospitalization time, chest tube duration, and postoperative complication rate. Relative to intact cysts, perforated cysts are more complex and are associated with more expensive and time-consuming surgical treatment.

Rupture of Right Hepatic Duct into Hydatid Cyst

Nickolaos Michalopoulos,Styliani Laskou,Theodossis S. Papavramidis,Ioannis Pliakos,Eustathios Kotidis,Isaak Kesisoglou,Spiros T. Papavramidis 대한의학회 2012 Journal of Korean medical science Vol.27 No.8

Echinococcal disease can develop anywhere in the human body. The liver represents its most frequent location. Hepatic hydatid cysts may rupture into the biliary tract, thorax,peritoneum, viscera, digestive tract or skin. We report a rare case with rupture of the right hepatic duct into a hydatid cyst in a woman with known hydatid disease and choledocholithiasis. The increased intra-luminal pressure in the biliary tree caused the rupture into the adjacent hydatid cyst. The creation of the fistula between the right hepatic duct and the hydatid cyst decompressed the biliary tree, decreased the bilirubin levels and offered a temporary resolution of the obstructive jaundice. Rupture of a hydatid cyst into the biliary tree usually leads to biliary colic, cholangitis and jaundice. However, in case of obstructive jaundice due to choledocholithiasis, it is possible that the cyst may rupture by other way around while offering the patient a temporary relief from his symptoms.

US and CT Findings of Splenic Hydatid Cyst: A Case Report

김일영,신형철,김상원,한종규 대한초음파의학회 2009 ULTRASONOGRAPHY Vol.28 No.1

Hydatid disease is a parasitic infection caused by the larvae of the cestode worms Echinococcus. In humans, the most commonly affected organ is the liver, the next second common organ is the lung. The third common affected organ is the spleen. In the case of splenic hydatid cyst, most cysts remain clinically silent and are diagnosed incidentally or when complications occur. We experienced a case of splenic hydatid cyst in a 28-year-old man. The patient complained of abdominal pain for 1 month. Abdominal ultrasound revealed a cystic lesion with daughter cysts in the spleen. The CT imaging also showed a cystic lesion with daughter cysts. We diagnosed it as a splenic hydatid cyst which was confirmed by pathology after surgery.

안와내 발생한 포충낭 1예

류지용,김근해,김숙영 대한안과학회 2006 대한안과학회지 Vol.47 No.3

Purpose: Most hydatid cysts affecting humans grow in the liver and the lung, but orbital involvement is very rare. To our knowledge, this is the first report of a hydatid cyst of the orbit in Korea. Methods: A 33-year-old woman came to the hospital with a 2-month history of slowly progressive proptosis and ocular pain of the right eye. The right eye showed proptosis, visual impairment and mild limitation of abduction. Orbital CT and MRI revealed a 32×20×24-mm well-defined unilocular cyst in the retrobulbar, intraconal area of the right orbit. Results: The cyst was surgically removed with lateral orbitotomy and it ruptured just prior to the end of the operation. Complete aspiration of the cystic fluid and in situ irrigation with gentamicin-normal saline mixture were performed. Histopathological examination revealed a hydatid cyst. After surgery, the visual acuity and primary position of the right eye were recovered, but its abduction was mildly limited.

복통을 동반한 간포충증 1예

김완철 ( Wan Chul Kim ),신재욱 ( Jae Uk Shin ),진수신 ( Su Sin Jin ) 대한소화기학회 2021 대한소화기학회지 Vol.77 No.1

Hydatid cysts are caused by an infestation with larval tapeworms of the genus Echinococcus. The disease is endemic in developing countries but has rarely been reported from immigrant workers in Korea. This paper reports a case of hepatic hydatid cyst in a 27-year-old female. She was referred with abdominal pain that had persisted for the past 2 months. The patient was a foreign worker from Mongolia. The physical examination was unremarkable, and blood tests showed peripheral blood eosinophilia and elevated liver enzymes. Abdominal ultrasonography showed a well-circumscribed cystic mass with septation in the liver. A surgical resection was performed for complete removal. After uncomplicated postoperative recovery, the patient was discharged with albendazole 400 mg twice daily. The hydatid cyst is an important disease that should be considered in the differential diagnosis of cystic lesions in the liver, particularly in those who have lived in endemic areas. A correct early diagnosis based on the typical image findings is important for early treatment before the rupture of the cyst, which is associated with low morbidity and mortality. A current surgical resection combined albendazole are effective treatments for hepatic hydatid cysts, associated with low recurrence rates. (Korean J Gastroenterol 2021;77:35-38)

Laparoscopic cystectomy for pancreatic echinococcosis

Ashraf Imam,Tawfik Khoury,Dani Weis,Harbi Khalayleh,Muhammad Adeleh,Abed Khalaileh 한국간담췌외과학회 2019 Annals of hepato-biliary-pancreatic surgery Vol.23 No.1

Cystic echinococcosis (CE) is a widely endemic helminthic disease caused by infection with the Echinococcus granulosus tapeworm. Following ingestion of eggs, hydatid cysts develop, most frequently in the liver and lungs, but occasionally in other organs. Infection of the pancreas by hydatid cysts is very rare, even in endemic areas. Most cases of pancreatic hydatid cysts reported in the literature were treated surgically using traditional open laparotomy. There are only few case reports describing laparoscopic treatment for this disease. Herein, we report on an eighteen-year-old female patient who was referred to our institution with a hydated pancreatic tail cyst. After a course of treatment with Albendazole, we successfully performed laparoscopic splenic-sparing distal pancreatectomy to remove the cyst with an uneventful intra- and post-operative course.

Surgical and Molecular Evaluation of Pediatric Hydatid Cyst Cases in Eastern Turkey

Unal Bakal,Sami Simsek,Ahmet Kazez 대한기생충학열대의학회 2015 The Korean Journal of Parasitology Vol.53 No.6

Cystic echinococcosis (CE) caused by Echinococcus granulosus is a major public health problem worldwide, including Turkey. The aim of the current study was to identify the strains and to estimate the potential risk factors of E. granulosus in operated pediatric cases in eastern Turkey. Ten pediatric patients (7 boys and 3 girls) living in rural areas, with ages ranging from 3 to 15 years old and various clinical histories, were included in this study. Eight patients had only liver hydatid cyst, while 1 patient had liver and lung hydatid cyst and the other liver, lung, and spleen, together. There were 2 ruptured liver cysts. After surgery, during follow-up, no increase was observed in hemagglutination levels, there were no mortalities, and there was no evidence of recurrence at 2 years post operation in all patients. Molecular analysis was performed on hydatid cyst samples obtained from the 10 pediatric cases. According to mt-12S rRNA PCR results, all cases were found to be G1/G3 cluster of E. granulosus sensu stricto.

Case Reports : Mesenteric Hydatid Cyst: An Unusual Presentation

( Sandhya Mittal ),( Bal Krishan Taneja ),( Anupama Goel ),( Meenu Puri ),( Pinky Pandey ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.5

Hydatidosis is a common zoonosis that affects a large number of humans and animals, especially in poorly developed countries. Mesenteric hydatid cysts are rare intra abdominal lesions with variable clinical symptoms and signs that make preoperative diagnosis diffi cult. The treatment is surgical excision followed by mebendazole for four months. We report this unusual case where preoperative diagnosis of right tubo-ovarian mass was made and the diagnosis of mesenteric hydatid cyst could be made only on laprotomy and microscopic examination after surgery.