[Budd-Chiari syndrome in liver echinococcosis]

Hepatic Encephalopathy in Connection With Budd-Chiari Syndrome due to Infection With Echinococcus Multilocularis: A Case Report

Budd-Chiari syndrome (BCS) is a hepatic venous outflow block generally resulting from disorders affecting hepatic venous system. Elevated hepatic venous pressure results in portal hypertension. BCS may also cause hepatic encephalopathy. Echinococcus multilocularis is a tapeworm parasite and the natural course of the disease may affect liver parenchyma as well as hepatic venous tree. It is the most terrible parasitic disease of the liver and is easily confused with hepatic malignancies. Albendazole therapy may suppress disease progression. Alveolar echinococcosis of the liver rarely causes Budd-Chiari syndrome-related hepatic encephalopathy (HE). We report a rare case of alveolar echinococcosis-related BCS with HE, who was successfully managed by rifaximin and albendazole.

Budd-Chiari syndrome owing to liver hydatid disease: case report and review of the literature

Liver hydatid disease causes significant morbidity but portal hypertension is a rare complication. The mechanism may be pre-hepatic, hepatic, or post-hepatic. Echinococcus granulosus or E. alveolaris may be involved; the latter is associated with infiltration and liver failure. A 13-year-old girl presented with two large unilocular liver hydatids complicated by chronic Budd-Chiari syndrome. Analysis of the ascitic fluid demonstrated a transudate and results of liver function tests were normal. CT scan showed compression at the level of the hepatic veins opening into the vena cava, with multiple collaterals. The patient underwent cystectomy and capittonage which was followed by reversal of the portal hypertension and ascites. This is probably only the second case to be reported in the English-language literature.

Cestodes. Echinococcus

This article deals with cystic echinococcosis (CE) and alveolar echinococcosis in humans caused by the cestode parasites Echinococcus granulosus and Echinococcus multilocularis. The life cycles of these parasites and their epidemiologic aspects are briefly discussed, and a detailed review is presented on clinical aspects of the diseases, including diagnosis and therapy. Considerable progress has been made in chemotherapy but the results are not yet satisfactory. A new alternative for treatment of CE is puncture of cysts, aspiration of fluid, injection of ethanol, and reaspiration of fluid (PAIR).