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Schandiz H, Nasser SNM, Ekeberg B, Pedersen MK, Leegaard TM, Sauer T. Human cystic echinococcosis detected in mesentery: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241287645. [PMID: 39483847 PMCID: PMC11526311 DOI: 10.1177/2050313x241287645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Accepted: 09/12/2024] [Indexed: 11/03/2024] Open
Abstract
Cystic echinococcosis, although rare in Europe, presents a diagnostic challenge when encountered, especially in atypical locations such as the mesentery. This case report is significant because it highlights the unique presentation of mesenteric hydatid cysts, emphasizing the importance of considering uncommon etiologies in differential diagnosis, particularly in immigrant populations. The novelty of this case lies in its rarity and the diagnostic dilemma it posed, ultimately leading to successful management through prompt recognition and accurate diagnosis. A 33-year-old pregnant female from East Africa presented with intermittent abdominal pain during pregnancy. Imaging revealed a cystic mass adjacent to the mesentery, initially misdiagnosed as an ovarian cyst. Postpartum, she developed acute abdominal symptoms, leading to a revised diagnosis of a ruptured hydatid cyst. Antiparasitic treatment and surgical intervention were initiated, resulting in successful management. This case underscores the necessity of prompt recognition and accurate diagnosis of rare conditions such as mesenteric hydatid cysts, particularly in immigrant populations. A multidisciplinary approach is crucial for optimal patient care in such cases.
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Affiliation(s)
- Hossein Schandiz
- Department of Pathology, Akershus University Hospital (Ahus), Akershus, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Campus Ahus, Oslo, Norway
| | - Salah NM Nasser
- Department of Radiology, Akershus University Hospital (Ahus), Akershus, Norway
| | - Bente Ekeberg
- Department of Pathology, Akershus University Hospital (Ahus), Akershus, Norway
| | - Mette K Pedersen
- Department of Pathology, Akershus University Hospital (Ahus), Akershus, Norway
| | - Truls M Leegaard
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Campus Ahus, Oslo, Norway
- Department of Microbiology and Infection Control, Akershus University Hospital (Ahus), Akershus, Norway
| | - Torill Sauer
- Department of Pathology, Akershus University Hospital (Ahus), Akershus, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Campus Ahus, Oslo, Norway
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Mihetiu A, Bratu DG, Tanasescu C, Vintilă BI, Sandu A, Sandu M, Serban D, Sabau D, Hasegan A. Laparoscopic Management of Multiple Liver, Omental, Mesenteric, Peritoneal, and Round Ligament Hydatid Cysts-A Rare Report of a Case and a Systematic Literature Review. J Pers Med 2024; 14:205. [PMID: 38392638 PMCID: PMC10890065 DOI: 10.3390/jpm14020205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
Hydatid cyst disease is a parasitic ailment with an endemic nature, predominantly affecting geographical areas with a tradition in animal husbandry. The most common localization of hydatid disease is in the liver (60%), followed by the lungs, with other organ localizations comprising less than 10%. The surgical approach to this condition can be carried out through open surgery or laparoscopy. The coexistence of hepatic and intraperitoneal hydatidosis often leads to the preference for open surgery. We performed a literature review aiming to retrieve data regarding demographic characteristics, clinical features, preoperative management, and surgical approach concerning these unusual localizations of hydatid disease. It was observed that the mesenteric localization frequently presented with acute abdominal pain (p = 0.038) and that the open approach was preferred in 85.71% of cases. Furthermore, an interdependence was identified between the localization of the cysts and the type of surgical approach (p = 0.001), with mesenteric localizations being approached through laparotomy and excision (p = 0.037), while omental localizations, due to the easier approach, benefited from laparoscopy with excision in 14.29% of cases. Overall, the laparoscopic approach was less frequently used, but its utilization resulted in a lower number of complications and faster recovery. Additionally, we present a rare case of hepatic and intra-abdominal hydatidosis, resolved exclusively through a laparoscopic approach, including a review of the literature for these uncommon localizations of hydatid disease. A 45-year-old patient diagnosed with multiple hydatid cysts, both hepatic and intraperitoneal, underwent surgical intervention with exploratory laparoscopy. Laparoscopic excision of peritoneal, epiploic, mesenteric cysts, and round ligament, along with laparoscopic inactivation, evacuation, and pericystectomy of hepatic hydatid cysts, was performed. The patient's recovery was uneventful, and she was reevaluated at 3 and 9 months without signs of recurrence. The association of hepatic hydatid cysts with multiple intra-abdominal localizations is not commonly encountered. The treatment of choice is surgical and is predominantly conducted through open surgery. The presented case is unique due to the exclusive laparoscopic approach in the management of mixed hepatic and intra-abdominal hydatidosis.
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Affiliation(s)
- Alin Mihetiu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Dan Georgian Bratu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Ciprian Tanasescu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Bogdan Ioan Vintilă
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Alexandra Sandu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Mariana Sandu
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Dragos Serban
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania
| | - Dan Sabau
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
| | - Adrian Hasegan
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania
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Kardoun N, Fendri S, Rejab H, Youssef M, Tlili A, Triki M, Toumi N, Trigui A, Boujelbene S. Primary cystic echinococcosis of the peritoneum: a case report. J Med Case Rep 2023; 17:541. [PMID: 38093379 PMCID: PMC10720152 DOI: 10.1186/s13256-023-04289-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Peritoneal cystic echinococcosis happens usually after traumatic rupture or after surgical treatment. Primary peritoneal cystic echinococcosis is a very rare case that constitutes a diagnostic and therapeutic challenge. CASE REPORT A 30-year-old Tunisian man was admitted for hypogastric pain since 4 months. He has a 10 cm hypogastric mass. Biological-tests were normal. A computed tomography Scan showed a cystic mass on the pelvis measuring 13 × 17 cm without echinococcosis cyst in the liver. The patient was operated and we found a cystic mass of 17 cm located on the Douglas cul-de-sac that suggest a pelvic hydatid cyst. We have performed an aspiration of the cyst confirms the diagnosis followed by injection of hypertonic solution, extarction of the germinal layer and a maximal reduction of the pericyst. The postoperative course was uneventful. CONCLUSION Trough our case, we try to focus on the diagnosis and therapeutic options of this rare entity that we should think of in front of a patient with isolated peritoneal cyst especially in endemic country.
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Affiliation(s)
- Nizar Kardoun
- General Surgery Department, Habib Bourguiba Hospital, University of Sfax, 0.5 Km El Ain Street, 3021, Sfax, Tunisia
| | - Sami Fendri
- General Surgery Department, Habib Bourguiba Hospital, University of Sfax, 0.5 Km El Ain Street, 3021, Sfax, Tunisia.
| | - Haitham Rejab
- General Surgery Department, Habib Bourguiba Hospital, University of Sfax, 0.5 Km El Ain Street, 3021, Sfax, Tunisia
| | - Mejdoub Youssef
- General Surgery Department, Habib Bourguiba Hospital, University of Sfax, 0.5 Km El Ain Street, 3021, Sfax, Tunisia
| | - Ahmed Tlili
- General Surgery Department, University Hospital of Gabes, University of Sfax, Sfax, Tunisia
| | - Meriam Triki
- Pathology Department, Habib Bourguiba Hospital, University of Sfax, 0.5 Km El Ain Street, 3029, Sfax, Tunisia
| | - Nozha Toumi
- Department of Radiology, Habib Bourguiba Hospital, University of Sfax, 0.5 Km El Ain Street, 3029, Sfax, Tunisia
| | - Ayman Trigui
- General Surgery Department, Habib Bourguiba Hospital, University of Sfax, 0.5 Km El Ain Street, 3021, Sfax, Tunisia
| | - Salah Boujelbene
- General Surgery Department, Habib Bourguiba Hospital, University of Sfax, 0.5 Km El Ain Street, 3021, Sfax, Tunisia
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A Pictorial Review of Mesenteric Pathologies on Computed Tomography with Pathological Correlation. Indian J Surg 2022. [DOI: 10.1007/s12262-021-03230-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Reddy R. Concurrent occurrence of primary mesenteric hydatid cyst with multiple calcified splenic granulomas: A rare presentation. APOLLO MEDICINE 2021. [DOI: 10.4103/am.am_50_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Paramythiotis D, Karakatsanis A, Bangeas P, Kofina K, Papadopoulos V, Apostolidis S, Michalopoulos A. Simultaneous Hepatic and Mesenteric Hydatid Disease-A Case Report. Front Surg 2017; 4:64. [PMID: 29209615 PMCID: PMC5702502 DOI: 10.3389/fsurg.2017.00064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 10/27/2017] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Hydatid cysts most commonly present in the liver and the lungs; however, they can appear more rarely in other locations, such as the mesentery, with a rather unclear mechanism of manifestation. Herein, we present a case of simultaneous presence of hydatid cysts in the liver and the mesentery of a young man. CASE REPORT A 39-year-old man was referred to our Department for further investigation of intermittent abdominal pain, especially in the right upper quadrant, and abdominal distension. Abdominal CT imaging revealed three calcified lesions, one in the liver, a similar adjacent to an ileal loop and one close to the urinary bladder, while antibody control was positive for echinococcal infection. The lesions were excised and the patient was discharged on the seventh post-operative day in good general condition. Post-operative control after 6 months did not show any signs of recurrence. CONCLUSION Simultaneous presence of hydatid cysts in two organs occurs in 5-13% of cases. Presence in the mesentery is extremely rare, although, should be included in the classic differential diagnosis, especially in endemic areas.
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Affiliation(s)
- Daniel Paramythiotis
- 1st Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Anestis Karakatsanis
- 1st Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Petros Bangeas
- 1st Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Konstantinia Kofina
- 1st Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Vassileios Papadopoulos
- 1st Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Stylianos Apostolidis
- 1st Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Antonios Michalopoulos
- 1st Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University Hospital of Thessaloniki, Thessaloniki, Greece
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Isolated Peritoneal, Mesenteric, and Omental Hydatid Cyst: A Clinicopathologic Narrative Review. IRANIAN JOURNAL OF MEDICAL SCIENCES 2017; 42:517-523. [PMID: 29184259 DOI: pmid/29184259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hydatid disease (HD) is caused by Echinococcus granulosus and is endemic in many parts of the world. This parasitic tapeworm can produce cysts in almost every organ of the body, with the liver and lung being the most frequently targeted organs. Peritoneum, omentum, and mesentery are among these unusual locations, which can cause diagnostic challenge and treatment delay. This review provides information on the reported cases of the peritoneal, omental, and mesenteric hydatid cyst in the world during the last 20 years. During the last 20 years, there have been 49 published cases of hydatid cysts in the peritoneum, mesentery, and omentum. Among the reported cases in the English literature, the most common presenting symptom has been chronic abdominal pain and the method of primary diagnosis has been ELISA and ultrasonography. The best treatment modalities have been surgical excision, with and without adjuvant therapy, with albendazole and scolicidal agents. The published follow-up studies showed a low recurrence rate.
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KERKENI Y, SAHLI S, GASMI M, SGHAIROUN N, HAMZAOUI M. A Rare Cause of Recurrent Vaginal Hydrocele: Herniating Mesenteric Hydatid Cyst. IRANIAN JOURNAL OF PARASITOLOGY 2017; 12:461-465. [PMID: 28979358 PMCID: PMC5623928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Echinococcosis is a multisystem disease and has propensity to involve any organ, an unusual anatomical site, and can mimic any disease process. The hydatid cyst of the mesenteries known to occur secondary to hepatic involvement but occasional cases of his primitive form has also been reported. We report here one such case of primitive mesenteric hydatid cyst herniated through inguinal canal in a 5-yr-old boy, admitted to our Pediatric Surgery Department of Children's Hospital in Tunis, Tunisia in 2015.
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