scholarly journals Intrabiliary and abdominal rupture of hepatic hydatid cyst leading to biliary obstruction, cholangitis, pancreatitis, peritonitis and septicemia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Manouchehr Aghajanzadeh ◽  
Mohammad Taghi Ashoobi ◽  
Hossein Hemmati ◽  
Pirooz Samidoust ◽  
Mohammad Sadegh Esmaeili Delshad ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Hydatid Disease ◽  
Biliary Obstruction ◽  
Abdominal Ultrasound ◽  
Sporadic Case ◽  
Gallbladder Wall ◽  
Liver Cyst ◽  
Biliary Duct ◽  
Wall Thickening

Abstract Background Hydatid cysts are fluid-filled sacs containing immature forms of parastic tapeworms of the genus Echinococcus. The most prevalent and serious complication of hydatid disease is intrabiliary rupture, also known as cystobiliary fistulae. In this study, a sporadic case of biliary obstruction, cholangitis, and septicemia is described secondary to hydatid cyst rupture into the common bile duct and intraperitoneal cavity. Case presentation A 21-year-old Iranian man was admitted to the emergency ward with 5 days of serious sickness and a history of right upper quadrant abdominal pain, fatigue, fever, icterus, vomiting, and no appetite. In the physical examination, abdominal tenderness was detected in all four quadrants and in the scleral icterus. Abdominal ultrasound revealed intrahepatic and extrahepatic biliary duct dilation. Gallbladder wall thickening was normal but was very dilated, and large unilocular intact hepatic cysts were detected in segment IV and another one segment II which had detached laminated membranes and was a ruptured or complicated liver cyst. Conclusion Intrabiliary perforation of the liver hydatid cyst is an infrequent event but has severe consequences. Therefore, when patients complain of abdominal pain, fever, peritonitis, decreased appetite, and jaundice, a differential diagnosis of hydatid disease needs to be taken into consideration. Early diagnosis of complications and aggressive treatments, such as endoscopic retrograde cholangiopancreatography and surgery, are vital.

scholarly journals ISOLATED PRIMARY HYDATID CYST OF THE PANCREAS: A CASE REPORT

2015 ◽  
Vol 8 (1) ◽  
Author(s):  
Mehmet Eren Yuksel ◽  
Bulent Aytac ◽  
Ahmet Karamercan
Keyword(s):  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Abdominal Ultrasound ◽  
The Body ◽  
Stage 4 ◽  
Primary Hydatid Cyst ◽  
Caucasian Female ◽  
Vague Abdominal Pain

Hydatid disease is caused by tapeworm Echinococcus granulosus. E. granulosus forms hydatid cysts in human body, mostly in the liver and the lung. However, isolated primary hydatid cyst of the pancreas is rarely seen. Hereby, we report a 40-year-old Caucasian female with a hydatid cyst in the body of the pancreas. The patient, complaining of vague abdominal pain was examined with abdominal ultrasound. The ultrasound scan of abdomen revealed an exophytic cystic lesion in the body of the pancreas, approximately 7.5x5 cm in size. The defined lesion was thought to be compatible with hydatid cyst stage 4-5. The  surgical team informed the patient about all possible treatment options. The patient was put on albendazole treatment, 400 mg twice daily, for two months. Despite the medical treatment, the patient complained about abdominal pain and discomfort affecting her daily life. Therefore, she decided for surgical intervention. Following the intraoperative application of scolicidal hypertonic 20% NaCl solution, partial cystectomy with capitonnage was performed. The patient did well postoperatively. Isolated primary hydatid cyst of the pancreas is rarely seen, however, it should be taken into account in the differential diagnosis of abdominal pain, especially in endemic areas. 

scholarly journals Management of a hepatic hydatid cyst ruptured into the retroperitoneum and the abdominal wall muscles: A case report

2021 ◽  
Vol 24 (3) ◽  
pp. 149-152
Author(s):  
Seifeddine Baccouche ◽  
◽  
Mohamed Hajri ◽  
Sarraj Achref ◽  
Hammadi Ben Chaabene ◽  
...  
Keyword(s):  
Hydatid Cyst ◽  
Abdominal Wall ◽  
Biliary Tract ◽  
Hydatid Disease ◽  
Abdominal Ultrasound ◽  
Exceptional Case ◽  
Hepatic Hydatid Cyst ◽  
Posterior Abdominal Wall ◽  
Long Time ◽  
Hepatic Hydatid

Introduction. Hydatid disease is a zoonosis caused by the tapeworm Echinococcus granulosus. The liver is the most commonly involved organ, followed by lungs. The most common complications of hepatic hydatid cyst are rupture into the biliary tract and secondary bacterial infection. However, rupture into the retroperitoneum and the abdominal wall muscles is exceptional. Case presentation. We describe an unusual case of a 27-year-old female who was referred to our department for right flank pain for four months. Abdominal ultrasound and CT scan revealed a huge hydatid cyst in liver segment VI fistulizing to the retroperitoneum and the lateral and posterior abdominal wall muscles, causing anterior displacement of the right kidney, with two other cysts in segment II and VIII. Surgery was performed associated with perioperative antiparasitic chemotherapy. The cysts were unroofed and a resection of the protruding domes was performed. The hydatid material in the retroperitoneum and the muscles were completely evacuated by aspiration. Follow-up showed no recurrence. Discussion. Hepatic hydatid cyst rupture usually occurs into biliary tract, pleural cavity, bronchial tree and intraperitoneal cavity. Rupture into the retroperitoneum and the lateral and posterior abdominal wall muscles is exceptional. To our knowledge, this complication has never been documented before. The hydatid disease may involve insidiously for a long time to lead to such a complication. Surgery was inevitable in our case. It allowed to treat both the hydatid cyst and its complication. Conclusions. A rupture into the retroperitoneum and the abdominal wall muscles as a complication of a liver hydatid cyst is exceptional. In this presentation, we noticed that hydatid cysts can reach an extremely large size while remaining for a long time asymptomatic. We aim to highlight the significance of preventive measures and public health education to fight against the hydatid disease in endemic areas.

A RARE CASE OF PRIMARY PANCREATIC HYDATID CYST CAUSING BILIARY TREE DILATATION

2021 ◽  
pp. 13-14
Author(s):  
R. Deepthi ◽  
Sai kumar Reddy. kami reddy ◽  
Nasin Usman
Keyword(s):  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Echinococcus Granulosus ◽  
Hydatid Disease ◽  
Rare Case ◽  
Biliary Tree ◽  
Cystic Lesions ◽  
Endemic Areas ◽  
Upper Abdominal ◽  
Ct And Mri

Echinococcus granulosus complex is the causative parasite of hydatid disease, endemic to regions with stock breeding and agriculture. We present a rare case of primary pancreatic hydatid disease in a 20-year-old female who had complaints of upper abdominal pain and epigastric fullness. The typical radiological ndings in ultrasound, CT and MRI helps to differentiate this lesion from other cystic lesions in the pancreas. Therefore this lesion should be kept as a differential in endemic areas

scholarly journals Intra-Abdominal Hydatid Cyst: Sociodemographics, Clinical Profiles, and Outcomes of Patients Operated on at a Tertiary Hospital in Addis Ababa, Ethiopia

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Engida Abebe ◽  
Temesgen Kassa ◽  
Mahteme Bekele ◽  
Ayelign Tsehay
Keyword(s):  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Addis Ababa ◽  
Abdominal Mass ◽  
Abdominal Ultrasound ◽  
Tertiary Hospital ◽  
Common Finding ◽  
Right Lobe ◽  
Clinical Profiles ◽  
The Right

Background. Hydatid cyst is caused by the tapewormEchinococcus granulosus. The abdomen, specifically the liver, is the most common site affected.Objective. Determine the presentation patterns, types of surgical management, and outcomes of patients operated for intra-abdominal hydatid cyst (IAHC).Methodology. A retrospective descriptive study of patients admitted and operated for IAHC from September 1, 2011, to August 31, 2015.Results. Forty-two patients whose age ranged from 10 to 65 (mean of 37 years) were operated on. Females comprised 27 (64.3%) of the patients. The commonest presenting complaint was abdominal pain (41, 97.6%). Abdominal mass was documented in 23 (54.7%) cases. Abdominal ultrasound (AUS) and CT were the main imaging studies done on 38 (90.5%) and 24 (57.1%) patients, respectively. Cysts measuring more than 10 cm in diameter were the most common finding in both studies. Liver was the primary site involved, 30 (71.4%) cases, the right lobe being the main side, 73%. Thirty-eight (90.5%) patients underwent deroofing, evacuation, marsupialization, and omentoplasty (DEMO). There was no perioperative death, but 4 (9.5%) of the patients had post-op complications.Conclusion. Abdominal pain was the most common presenting complaint. AUS and CT remain the preferred imaging. DEMO was the most common surgery.

scholarly journals Clinical profile and surgical outcome of abdominal hydatid cyst at a university hospital in Nepal

2018 ◽  
Vol 5 (2) ◽  
pp. 52-57
Author(s):  
Shanta Bir Maharjan ◽  
Sanjaya Paudyal ◽  
Sailendra Shah ◽  
Romi Dahal ◽  
Jay Narayan Shah
Keyword(s):  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Open Surgery ◽  
Liver Cyst ◽  
University Hospital ◽  
Successful Outcome ◽  
Surgical Approaches ◽  
Mortality Data ◽  
Hydatid Cysts ◽  
Splenic Cysts

Introductions: Hydatid cyst is caused by the tapeworm. It is common in sheep and cattle rearing communities. Liver is the most common affected organ. There are various methods of surgical approaches for hydatid cyst. Methods: This was a retrospective descriptive study of patients operated for intra-abdominal hydatid cysts from July 2012 to June 2018 at Patan Hospital, Patan Academy of Health Sciences, Nepal. Ethical approval from institutional review committee was obtained. Patient files with incomplete data were excluded. Variables analyzed were, age, gender, site and numbers of cyst, methods of surgery, complications and mortality. Data were descriptively analyzed. Results: There were 19 patients of abdominal hydatid cysts who underwent surgery during the study period. Five records files could not be accessed and were excluded. In remaining 14, male were 6 (42.85%), female 8 (57.15%), mean age 39.57±17.35 years (14-70), cyst size 11±4.22 cm (5-21), complain of abdominal pain in 10 (71%). Open surgery for liver cyst was done in 11 and laparoscopic in one, and open splenectomy for two splenic cysts. One patient developed superficial wound infection. Four had cystobiliary communication of which one underwent ERCP. Post ERCP patient developed acute severe pancreatitis and expired.Mean hospital was 8.57±2.24 days (6-14). Conclusions: Liver was the main organ involved, abdominal pain and lump were main presenting complaints. Surgery had successful outcome. Open surgery was the mainstay of treatment.

Case 3.13

2014 ◽  
pp. 156-157
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Abdominal Pain ◽  
Gallbladder Wall ◽  
Severe Abdominal Pain ◽  
Wall Thickening ◽  
Abdominal Ct ◽  
Gallbladder Wall Thickening

25-year-old man who had an episode of severe abdominal pain following a meal; abdominal CT was abnormal Coronal SSFSE images (Figure 3.13.1) demonstrate focal dilatation of the mid CBD, as well as moderate gallbladder wall thickening. Axial and coronal 3D SPGR images (...

scholarly journals 317. Case Series of Echinococcus Infections at Mayo Clinic Florida

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S230-S231
Author(s):  
Eugene P Harper ◽  
Justin Oring ◽  
Harry Powers ◽  
Courtney E Sherman ◽  
Benjamin Wilke ◽  
...  
Keyword(s):  
Hydatid Cyst ◽  
Hydatid Disease ◽  
Echinococcus Multilocularis ◽  
Q Fever ◽  
Liver Cyst ◽  
Chest Ct ◽  
Flank Pain ◽  
Type I ◽  
X Ray ◽  
Fluid Collections

Abstract Background Echinococcus multilocularis is a destructive zoonotic cestode with low human incidence. Hydatid disease classically presents with hepatic or lung involvement with infrequent extrahepatic bone destruction. Diagnosis is challenging due to its latency and mimicry. Fig.1: Case 1 - X-ray imaging of the pelvis shows osseous destruction of the iliac crest secondary to known osteomyelitis status post left ilium debridement. Fig.2: Case 1 - Magnetic resonance imaging demonstrates extensive osteomyelitis throughout left ilium. Stable scattered focal fluid collections seen throughout the left lower quadrant. Methods CASE 1: A 57 year-old Albanian male with diabetes, latent TB, and left iliac lytic lesion presented with 4 weeks of left flank pain and was treated with 6 weeks of IV Ceftriaxone and Flagyl. 2 years later he returned with flank pain and purulent lumbar drainage. Hip x-ray suggested chronic osteomyelitis, with left psoas fluid collections on CT. Bartonella, Q fever, Brucella, HIV, AFB and fungal serologies were negative. Hemipelvis debridement revealed structures concerning for hydatid disease. Echinococcus IgG was equivocal. Histopathology was consistent with Echinococcus multilocularis species, and albendazole was started. On follow-up, he presented with left hip tenderness and toe extensor weakness. Labs showed mild leukocytosis. CT revealed progressive destruction of the left iliac with sacroiliac extension concerning for abscess. CASE 2: A 36 year-old female presented with lung and liver cysts, progressive dyspnea, and non-productive cough. She lived in Africa, Asia, and Europe and consumed local street food and unpasteurized milk. Hobbies included spelunking and swimming in freshwater lakes. She had exposure to stray animals, but denied bites or scratches. Over 4 years dyspnea progressed to orthopnea. MR abdomen revealed a 10x6x12cm liver cyst and chest CT showed 2 fluid-attenuating lesions in the LLL and RLL, measuring 4.9 x 6.0 cm and 6.8 x 4.3 cm respectively. Echinococcus, Bartonella, Q fever, Brucella, HIV, AFB and fungal serologies were negative. Schistosomiasis serology was equivocal. Fig. 3: Case 2 - MRI abdomen demonstrating 10x6x12cm liver cyst Fig. 4: Case 2 - Chest CT showed 2 dominant fluid attenuating lesions within the LLL and RLL. The larger lesion in RLL measures 6.8 x 4.3 cm. The left lower lobe lesion measures 4.9 x 6.0 cm. Results Patient 1 underwent type I hemipelvectomy. Patient 2 underwent pulmonary segmentectomy and liver lobectomy. Both were continued on albendazole. Fig. 5: Case 1 - Photo taken during debridement of left ileac and hip. Note presence of white cysts discovered intraoperatively. Fig. 6: Case 1 - Histopathologic slides (H&E stain) demonstrating hooks and scolices consistent with Echinococcus multilocularis. A. Hooklet (100x magnification). B. Hydatid cyst with black-staining structures suggestive of degenerating hooklets. C. Zoomed detail of cyst wall. D. Degenerating hydatid cyst and hooklets. Conclusion Equivocal IgG serology does not exclude infection. History and clinical presentation are key to diagnosis, but histopathology remains the gold standard. Hydatid bone infection progresses insidiously and frequently recurs, depending upon excision and debridement. Finally, echinococcosis demands aggressive long-term therapy and surveillance. Disclosures Claudia R. Libertin, MD, Pfizer, Inc. (Grant/Research Support, Research Grant or Support)

scholarly journals Toothpick Perforation of the Intestines Presenting as Recurrent Abdominal Pain: Possible Roles of Abdominal Ultrasound and MRI

2013 ◽  
Vol 6 ◽  
pp. CCRep.S11486 ◽  
Author(s):  
Robert J. Sealock ◽  
Saman Sabounchi ◽  
David Y. Graham
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Ileocecal Valve ◽  
Abdominal Ultrasound ◽  
Recurrent Abdominal Pain ◽  
Small Bowel Resection ◽  
Wall Thickening ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Bowel Wall Thickening

We report the case of a middle-aged man admitted for five months of unexplained left lower quadrant pain. He had been hospitalized on two prior occasions and treated with broad spectrum antibiotics. His clinical presentation was suggestive peritoneal irritation with severe, focal pain on abdominal palpation. Computed tomography scans showed non-specific inflammation in the left lower abdomen with adjacent small bowel wall thickening. Upper endoscopy and colonoscopy were unremarkable on prior admission. Given the severity and focality of the patient's recurrent abdominal pain he underwent laparoscopy and was found to have a wooden toothpick perforation of the small bowel thirty centimeters from the ileocecal valve requiring partial small bowel resection. The patient did well post-operatively. On retrospective questioning he may have eaten a cabbage roll or bacon wrapped shrimp pierced with a toothpick weeks before the onset of symptoms. Toothpick perforation should be a consideration in edentulous persons with focal, severe abdominal pain and trans-abdominal ultrasound or MRI may be a better choice for detecting wooden foreign objects.

Gallbladder Wall Thickening in Acute Pyelonephritis

1990 ◽  
Vol 18 (8) ◽  
pp. 653-657 ◽  
Author(s):  
Henry P. Talarico ◽  
Deborah Rubens
Keyword(s):  
Acute Pyelonephritis ◽  
Gallbladder Wall ◽  
Wall Thickening ◽  
Gallbladder Wall Thickening

Clinical Usefulness of Endoscopic Ultrasonography in the Differential Diagnosis of Gallbladder Wall Thickening

2011 ◽  
Vol 57 (2) ◽  
pp. 508-515 ◽  
Author(s):  
Hong Joo Kim ◽  
Jung Ho Park ◽  
Dong Il Park ◽  
Yong Kyun Cho ◽  
Chong Il Sohn ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Endoscopic Ultrasonography ◽  
Gallbladder Wall ◽  
Clinical Usefulness ◽  
Wall Thickening ◽  
Gallbladder Wall Thickening
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