Cases reported "Echinococcosis, Hepatic"

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1/276. Spontaneous rupture of hepatic hydatid cyst causing inferior vena cava thrombosis.

    We report a patient with an infected hepatic hydatid cyst, which spontaneously ruptured into the inferior vena cava, with resultant thrombosis of the inferior vena cava, and left renal, right common iliac and right external iliac veins.
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2/276. Pseudocholelithiasis in an elderly man with calcified hydatid cysts.

    A 69 year old man with intrabiliary rupture of a calcified echinococcal cyst mimicking acute cholelithiasis is discussed. This case is of interest because the correct diagnosis was not recognized preoperatively despite the fact that certain aspects of the illness were classic features of this complication of hydatid disease. Although this is a common complication of hydatid disease, which is well recognized in other countries, only seven cases have been reported in the American literature. Treatment of our patient included successful use of a Roux-en-Y drainage procedure which, to the best of our knowledge, has not previously been employed in treating this disease.
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3/276. Percutaneous treatment of hepatic hydatid cyst in pregnancy.

    A 20 cm hepatic hydatid cyst with daughter cysts, was diagnosed in a primigravida in the fifteenth week of pregnancy and was managed percutaneously. No complications occurred and the patient subsequently gave birth to a healthy baby.
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4/276. Correlative CT, MRI and histological findings of hepatic Echinococcus alveolaris: a case report.

    diagnosis of liver infestation by Echinococcus alveolaris (EA) is based on serologic, sonographic and CT findings. literature review yielded only one report discussing the MRI findings of hepatic EA infestation. In this report, we present a case of hepatic EA infestation with its correlative CT, MRI and histological findings. CT showed hypodense mass involving more than half of the liver with rim and central calcifications. MRI revealed hypointense signal of the infiltrative mass on both T1- and T2-weighted images. On MRI, the portal vein branches were seen coursing through the lesion. Neither CT nor MRI demonstrated any contrast enhancement of the mass. On the histological examination, abundant fibrous and hyalinized tissue surrounding multiple small cysts were observed. MRI may provide invaluable information in the diagnosis of EA infestation of the liver, either by disclosing the infiltrative pattern of infestation without significant effect to vascular structures, or by the signal characteristics.
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5/276. Single stage removal of right pulmonary and hepatic hydatid cysts.

    A case of hydatid disease of lung and liver is described. The patient was investigated because of a circumscribed shadow in the right lung on chest skiagram. Another cystic shadow was picked up in the right lobe of liver on ultrasound examination. Both the cysts in right lung and liver were removed simultaneously through a right thoracophrenotomy. Emphasis is being laid on the utilization of single stage thoracotomy as an operative procedure of choice for hydatid cysts of right lung and liver.
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6/276. Fine-needle aspiration diagnosis of hydatid cyst.

    The diagnosis of hydatid disease outside endemic areas is usually not suspected. Hydatid cysts in imaging studies can be confused with hepatic tumors, abscesses, cystadenomas, liver cysts or other lesions. serology is the usual confirmatory test, but cytologic diagnosis has been described. Aspiration of the cysts has not been employed as a routine diagnostic method for fear of spillage and anaphylactic reactions. We report a case of unsuspected hepatic echinococcosis that was confirmed by fine-needle aspiration of the lesion and cytologic confirmation without complications.
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keywords = cyst
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7/276. Management of a patient with hepatic-thoracic-pelvic and omental hydatid cysts and post-operative bilio-cutaneous fistula: a case report.

    In humans, most hydatid cysts occur in the liver and 75% of these are single. Our patient was a 31 year-old male. His magnetic resonance imaging (MR) showed one cyst (15 x 20 cm) in the right lobe and three cysts (5 x 6 cm, 8 x 6 cm, and 5 x 5 cm) in the left lobe of the liver, two cysts (4 x 5 cm and 5 x 5 cm) on the greater omentum, and two cysts (15 x 10 and 10 x 10 cm) in the pelvis. The abdomen was entered first by a bilateral subcostal incision and then by a Phennenstiel incision. Partial cystectomy capitonnage was done on the liver cysts; the cysts on the omentum were excised, and the pelvic cysts were enucleated. The cyst in the right lobe of the liver was in communication with a thoracic cyst. An air leak developed from the thoracic cyst which had underwater drainage and bile drainage from the drain in the cavity of the right lobe cyst. Sphincterotomy was done on the seventh post-operative day by endoscopic retrograde cholangiopancreatography (ERCP). No significant effect on mean bile output from the fistula occurred. octreotide therapy was initiated, but due to abdominal pain and gas bloating the patient felt and could not tolerate, it was stopped on the fourth day; besides, it had no decreasing effect on bile output during the 4 days. Because air and bile leak continued and he had bile stained sputum, he was operated on on post-operative day 18. By right thoracotomy, the cavity and the leaking branches were closed. By right subcostal incision, cholecystectomy and T-tube drainage of the choledochus were done. On post-operative day 30, he was sent home with the T-tube and the drain in the cavity. After 3 months post-operatively, a second T-tube cholangiography was done, and a narrowing in the distal right hepatic duct and a minimal narrowing in the distal left hepatic duct were exposed. Balloon dilatation was done by way of a T-tube. bile drainage ceased. There was no collection in the cavity in follow-up CT scanning, so the drain in the cavity, and the drainage catheter in the right hepatic duct were extracted. Evaluation of the biliary ductal system is important in bilio-cutaneous fistulas, and balloon dilatation is very effective in fistulas due to narrowing of the ducts.
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8/276. Reversible platypnoea and orthodeoxia after surgical removal of an hydatid cyst from the liver.

    A patient with a large hydatid cyst of the liver developed a positionally symptomatic right to left shunting across a patent foramen ovale with both platypnoea and orthodeoxia, despite normal pulmonary arterial pressures and normal pulmonary function tests. When the patient was in the supine position the calculated right to left shunt was 15.1% and 29.5% when seated. The shunt was attributed to the compression of the right atrium and ventricle by the cyst. Surgical evacuation of the cyst relieved the symptoms and the positionally induced shunting.
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ranking = 1.4
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9/276. Cystic echinococcosis in a Jordanian patient: albendazole in a short-term immigrant.

    With an ever increasing number of international travelers, physicians should be aware of the diseases that have rarely been encountered in their home countries. Cystic echinococcosis (CE) caused by echinococcus granulosus is seldom seen in japan despite frequent occurrence of the other type of echinococcosis, alveolar echinococcosis (AE) caused by E. multilocularis, in its northern parts. However, CE is prevalent in many parts of the world including the United Kingdom, Mediterranean basin, middle east, south america, and australia, and is supposed to be resurgent in several parts of the world. The disease is acquired by the oral ingestion of the eggs of E. granulosus passed into the feces of several definitive host animals carrying tapeworms, mostly dogs. These definitive hosts are infected by cannibalizing intermediate host animals including sheep and cattle whose livers and/or lungs are affected by cystic lesions that contain protoscoleces. In endemic areas the diagnosis of CE is not considered to be complicated; typical morphological features composed of cysts as revealed by ultrasonography and/or computerized tomography (CT) scan. The diagnosis is also aided by serological methods detecting serum antibodies. However, imaging procedures show a variety of features that could often lead to misdiagnosis as other diseases. Moreover, serological assays are sometimes difficult to interpret because of their incomplete sensitivities and specificities. Hence, a comprehensive understanding of a spectrum of imaging features and the application of serological methods with better sensitivities and specificities are indispensable. The mainstay of treatment of the disease is still surgical removal of cysts that has the potential to lead to a complete cure. Recently, the less invasive method PAIR (Puncture of cysts percutaneously, Aspiration of fluid, Introduction of protoscolicidal agent, and Reaspiration) was introduced with considerable success, and could be a promising alternative to surgery. Lastly, medical treatment with oral mebendazole or albendazole, especially the latter, can be beneficial not only as a adjunctive to surgery or PAIR, but as a sole treatment in cases in which invasive methods are not indicated. Here we report a Jordanian patient with CE whose diagnosis was substantiated by a novel immunoblot assay and who showed a rapid improvement during albendazole therapy.
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10/276. Hydatid liver disease as a cause of recurrent pancreatitis.

    Intrabiliary rupture of a hydatid liver cyst is infrequently reported, but may present with symptoms of choledocholethiasis or cholangitis. We report a case of hydatid liver disease presenting as recurrent pancreatitis, and discuss its clinical, radiological and surgical treatments. Hydatid liver disease has a diverse clinical spectrum, and a diagnosis of acute pancreatitis should be considered in patients with hydatid liver disease presenting with unexplained abdominal pain.
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ranking = 0.2
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