Isolated mesosigmoidal hydatid cyst as an unusual cause of colonic obstruction: report of a case

Hydatid cysts in the mesocolon mimicking peritoneal pseudomyxoma in a post-appendectomy patient: A case report

We aimed to present a case of two mesocolonic hydatid cysts that mimicked the presentation of peritoneal pseudomyxoma. Hydatidosis is a zoonotic parasitic infection caused by the cestode Echinococcus spp., whose larval stage affects various organs. The present case describes a 40-year-old male patient who presented with severe lower abdominal pain and was diagnosed with acute appendicitis. The patient underwent an appendectomy and was later referred to an oncology surgery clinic because of imaging findings suggestive of peritoneal pseudomyxoma or carcinomatosis. A video-assisted laparoscopic procedure revealed two cysts and microscopic findings confirmed hydatid cysts. The patient was from a hydatidosis-endemic region of southern Brazil. This case highlights the diagnostic challenges and the need for a multidisciplinary approach and careful histopathological analysis in patients with complex abdominal conditions. This also demonstrates the importance of disseminating knowledge about this condition and its management.

Pelvic and peritoneal hydatidosis: An uncommon presentation of the common entity

Key Clinical Message

The pelvic and peritoneal hydatidosis occurs mostly after the traumatic rupture or surgical spillage of Echinococcus from liver or spleen. The treatment is surgical aiming to eradicate local disease, preventing complications, and reducing recurrences.

Abstract

We report a unique case of a 26-year-old male who presented with acute urinary retention and abdominal distention. Later, CT-urography revealed peritoneal and pelvic hydatidosis behind this presentation, which was managed surgically.

Hydatid cysts of the liver with concomitant massive peritoneal hydatidosis: a case report

The worldwide distribution of Echinococcus granulosus and its capability to persist in the human organism by causing serious medical and economical damage makes this parasite popular in terms of diagnosis and treatment implementation. Besides the liver as the primary target organ for this parasite, cases of secondary peritoneal hydatidosis are reported. Although rarely, they present with unusual abdominal symptoms with a bizarre presentation on abdominal ultrasound and Computerized Tomography scans. We present a case of a 44 years old male patient with concomitant presence of liver hydatid cysts and massive peritoneal hydatidosis treated with a combination of surgery and postoperative medications. The treatment of peritoneal hydatidosis consists of surgical removal of all the present cysts. In addition, anti-parasitic drugs are recommended to prevent a recurrence. The concomitant presence of liver hydatid cysts and peritoneal echinococcosis can appear as a result of abdominal trauma or iatrogenic spillage during abdominal surgery.

Hydatid cyst of the colon: A systematic review of the literature

BACKGROUND

Primary hydatid disease in the colon is an extremely rare finding. We performed a systematic review of cases of hydatidosis of the colon published to date.

AIM

To systematic review the published papers about hydatidosis of the colon.

METHODS

Following PRISMA guidelines, we performed an unlimited search for articles on CH in the MEDLINE (PubMed), EMBASE, Cochrane, Latindex and Scielo databases, published in English, Spanish, French, German or Italian between January 1, 1960 and December 15, 2018. The search items were: (Colon) AND [(hydatidosis) OR (hydatid disease) OR (echinococcosis)].

RESULTS

Nine case reports were found [five men, four women, median age 64.55 years (range: 21-81)]. The most frequent clinical manifestation was abdominal pain (8/9) (88.9%). In almost all cases several image studies were carried out, but abdominal computed tomography was the most used (66.7%). Five resections of the colon (62.5%) and three sutures of the fistula between cyst and colon (37.5%) were performed. Four patients did not present post-operative complications, but one died. Postoperative period was recorded for a mean period of 35 months. No recurrences were recorded.

CONCLUSION

The most frequent symptom was abdominal pain (evidence level 4). Computed tomography was the most frequently used diagnostic imaging technique (evidence level 4). Colectomy was the most appropriate treatment (evidence level 5). All the diagnostic and therapeutic options for hydatid cysts located in colon have a low level of evidence.

Intraluminal cecal hydatid cyst presented as chronic intestinal obstruction

A 70-year-old male presenting with abdominal pain was clinically diagnosed to have chronic intestinal obstruction due to lesion in ileo-cecal junction based on barium meal follow through. He underwent right hemicolectomy and the lesion was ascertained to be an intraluminal hydatid cyst in the caecum. Intraluminal cecal hydatid cysts can mimic malignancy on radiological investigations. It should be considered as a differential diagnosis in patients presenting with intestinal obstruction in endemic regions for hydatid disease.

Primary peritoneal hydatidosis

Hydatid disease is a parasitic infestation caused by the tapeworm Echinococcus granulosus. Echinococcosis occurs worldwide and can affect multiple organs. The liver (75%) and the lungs (15%) are the most common sites of occurrence followed by the spleen, kidney, bones and brain. Peritoneal hydatidosis commonly occurs secondary to a ruptured hydatid cyst of the liver or the spleen. Primary peritoneal hydatidosis is an extremely rare entity accounting for just 2% of all intra-abdominal hydatid disease. Most patients remain asymptomatic for years before presenting with vague abdominal symptoms such as non-specific pain, abdominal fullness, dyspepsia, anorexia and vomiting. We successfully treated a 55-year-old woman with primary peritoneal hydatidosis. The role of imaging and immunological tests in the diagnosis is highlighted. The patient was managed by a combination of preoperative and postoperative antihelminthic therapy along with laparotomy, cyst deroofing, toileting and omentoplasty. The patient is asymptomatic at 1-year follow-up.

Primary Peritoneal Hydatidosis in a 76-Year-Old Farmer: An Unusual form of a Common Disease

A 76-year-old farmer presented at our emergency unit with a history of gradual swelling of abdomen without fever, nausea, or urticaria. On examination there was symmetrical enlargement of abdomen with fluid thrill. Contrast-enhanced computed tomography scan showed that the entire peritoneal cavity was distended and occupied by multiloculated noncalcified content of mixed attenuations. Diagnosis of peritoneal seeding of hydatid cyst was made. At laparotomy, about 25 l of daughter cysts and a membrane was found in the peritoneal cavity without other organ involvement. Postoperative period was uneventful.

Primary disseminated extrahepatic abdominal hydatid cyst: a rare disease

Hydatid disease (HD) is a parasitic disease, most frequently caused by Echinococcus granulosus or Echinococcus multilocularis and rarely by Echinococcus vogeli or Echinococcus oligarthus. Mostly, hydatid cyst is primarily in liver (75%) and lung (15%). Peritoneal HD (13%) is usually secondary. Dissemination of HD may occur following rupture of the hydatid cyst into the peritoneal cavity. Primary peritoneal hydatid cyst disease is a rare phenomenon. We present a case of primary disseminated abdominal HD presenting with the complaint of a pain in the epigastric region along with intermittent fever. Radiological evaluation and serological examination confirmed it as primary disseminated HD involving pancreas, a cyst anterior to the left lobe of the liver just below the peritoneum and the left kidney.

Peritoneal hydatidosis: A rare form of a common disease

Hydatid disease caused by Echinococcus granulosus is a common parasitic infection of the liver. Disseminated intra-abdominal hydatid disease may occur following a rupture of the hydatid cyst into the peritoneal cavity producing secondary echinococcosis. Rarely, the cyst may develop de novo in the peritoneal cavity without the involvement of any other intra-abdominal organ. We present a unique case of a 57-year-old man with a primary intra-abdominal hydatid cyst.

Peritoneal hydatidosis in a young girl

We report a case of peritoneal hydatidosis that occurred post laparotomy. Patient was diagnosed nine months after she had laparotomy for suspected acute appendicitis. The whole peritoneal cavity was studded with cysts. In view of diffuse involvement, patient was managed conservatively and showed response to medical therapy.

Mucinous cystic neoplasms of the mesentery: a case report and review of the literature

Background

Mucinous cystic neoplasms arise in the ovary and various extra-ovarian sites. While their pathogenesis remains conjectural, their similarities suggest a common pathway of development. There have been rare reports involving the mesentery as a primary tumour site.

Case presentation

A cystic mass of uncertain origin was demonstrated radiologically in a 22 year old female with chronic abdominal pain. At laparotomy, the mass was fixed within the colonic mesentery. Histology demonstrated a benign mucinous cystadenoma.

Methods and results

We review the literature on mucinous cystic neoplasms of the mesentery and report on the pathogenesis, biologic behavior, diagnosis and treatment of similar extra-ovarian tumors. We propose an updated classification of mesenteric cysts and cystic tumors.

Conclusion

Mucinous cystic neoplasms of the mesentery present almost exclusively in women and must be considered in the differential diagnosis of mesenteric tumors. Only full histological examination of a mucinous cystic neoplasm can exclude a borderline or malignant component. An updated classification of mesenteric cysts and cystic tumors is proposed.

Primary abdominal hydatid cyst presenting in emergency as appendicular mass: a case report

Hydatid disease, caused by Echinococcus granulosus, is a common parasitic infection of the liver. Disseminated intra-abdominal hydatid disease may occur following rupture of the hydatid cyst into the peritoneal cavity, producing secondary echinococcosis. Rarely cyst may develop de-novo in the peritoneal cavity without involvement of any other intra-abdominal organs. We present a unique case of 56-year-old woman with a primary intraabdominal hydatid cyst in the right iliac fossa masquerading as appendicular lump.

Primary extrahepatic abdominal hydatidosis

INTRODUCTION

Most of the abdominal hydatid cysts occur in liver. Extrahepatic hydatid cyst is usually secondary to rupture (operative and non-operative) of the hepatic hydatid cyst. Primary extrahepatic hydatid cysts are rare and only a few sporadic cases have been reported.

MATERIAL AND METHODS

One hundred and eighty-three patients with abdominal hydatid cysts managed surgically from January 1998 to December 2003 were evaluated retrospectively. Twelve (6.5%) patients had only extrahepatic abdominal involvement.

RESULTS

The cysts were present in spleen (2.2%), pancreas (1.1%), peritoneum and pelvis (1.6%), gallbladder (0.6%), mesocolon (0.6%) and adrenal (0.6%).

DISCUSSION AND CONCLUSIONS

It is difficult to diagnose extrahepatic echinococcosis as it usually is not suspected. Symptoms are related to size, location or ensuing complication of the cyst. It should be strongly suspected in differential diagnosis of all abdominal cysts especially in an endemic area.

Epidemiology, clinical manifestations and diagnosis of zoonotic cestode infections: an update

This paper reviews the literature on zoonotic cestode infections with specific reference to the years 1999-2003. The sources and prevalence of various zoonotic tapeworm infections caused by adult and larval stages of the genera Taenia, Echinococcus, Diphyllobothrium, Hymenolepis and Dipylidium continue to be an important cause of morbidity and mortality, not only in most underdeveloped countries but also in industrialized countries, particularly in rural areas or among immigrant groups from endemic areas. The review gives a detailed report on recent molecular epidemiological studies on the taxonomy and phylogenetic variations in Echinococcus granulosus, immunological tests and imaging techniques used in epidemiological surveys and clinical investigations of important adult and larval tapeworm infections of animals and humans. Larval stages or metacestodes of Taenia solium, Echinococcus spp. and pseudophyllidean tapeworms (Spirometra syn. Diphyllobothrium spp.) may reside in various tissues of their intermediate hosts, including humans. In particular, Cysticercus cellulosae (T. solium) and the larvae of E. granulosus, and E. multilocularis, which are predominantly located in the liver, lungs and central nervous system forming various types of cysts, lead to a complex of systemic diseases such as cysticercosis, cystic echinococcosis and alveolar echinococcosis, respectively. Relatively rare clinical manifestations are seen in the muscles, subcutaneous tissue, spleen, kidneys, bones and body cavities.