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Messaoud O, El Haddad S, Cherraqi A, Allali N, Chat L. Tension Hydropneumothorax Caused by a Ruptured Hydatic Cyst in the
Pleural Cavity: Case Report. Glob Pediatr Health 2023; 10:2333794X231156044. [PMID: 36968457 PMCID: PMC10031588 DOI: 10.1177/2333794x231156044] [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: 08/30/2022] [Accepted: 01/20/2023] [Indexed: 03/24/2023] Open
Abstract
Hydatid disease is a zoonosis caused by a larva of the tapeworm Echinococcus. All
organs can be involved, but it is frequently located in liver for adults and
lung for children. The clinical features are nonspecific. Imaging findings has
an important place in the diagnosis and the follow-up. Rupture is the most
common complication of a hydatic cyst and has a variety of imaging findings
depending on the ruptured layer, the amount of air within the cyst and the type
rupture. We report the case of a 10-year-old boy presenting shortness of breath
and fever among other symptoms revealing by chest X-ray and thoracic CT scan, a
lung ruptured hydatic cyst to the pleural cavity causing a tension
hydro-pneumothorax and a superadded infection.
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Affiliation(s)
- Ola Messaoud
- Mother and Child Hospital IBN SINA,
Rabat, Morocco
- Ola Messaoud, Centre
Hospitalo-Universitaire Ibn Sina, International Hospital IBN SINA, Rabat 10170,
Morocco.
| | | | | | - Nazik Allali
- Mother and Child Hospital IBN SINA,
Rabat, Morocco
| | - Latifa Chat
- Mother and Child Hospital IBN SINA,
Rabat, Morocco
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Sadjjadi FS, Hajjaran H, Sedaghat B, Mardani P, Sadjjadi SM. Proteomics investigation of human sera for determination of postoperative indicators of pulmonary cystic echinococcosis. J Cardiothorac Surg 2023; 18:18. [PMID: 36631795 PMCID: PMC9832791 DOI: 10.1186/s13019-023-02109-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 01/02/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Cystic echinococcosis (CE)/hydatidosis is an important zoonotic parasitic disease caused by the larval stage of Echinococcus granulosus. The disease is a major health problem all over the world. Finding specific and sensitive biomarkers for follow-up of CE in patients after surgery is essential. Using proteomics methods, the present study aimed to evaluate post-surgical treatment by finding probable biomarker/s in the serum of human lungs CE. METHODS A total of 24 human sera were tested. These sera included eight confirmed lung/s CE patients sera before surgery (BS), eight sera 12 months post-surgery (12MPS) as well as eight control sera from healthy people. Proteomics methods including 2DE and LC-MS/MS were performed on the specimens followed by bioinformatics analysis. Differentially expressed proteins (DEP) were detected and, separately integrated with protein-protein interaction (PPI) data to construct the PPI network. RESULTS A total of 171 protein spots were detected in three groups including BS, 12MPS, and control groups; of which a total of 106 DEP have been expressed based on fold changes > = 2 and p-value < 0.05. More analysis was performed and a total of 10 protein spots were selected for identification by mass spectrometry showing the following proteins: APOA1, BGN, SPP2, EAF1, ACOXL, MRPL55, MCTP2, SEPTIN1, B4GALNT1, and ZNF843. Based on centrality parameters of the PPI network (degree and betweenness) five Hub-bottlenecks proteins with significant centrality values were found including APOA1, BGN, SPP2, EAF1, and ACOXL. CONCLUSION This study showed five proteins as hub-bottleneck proteins; of which APOA1 was more prominent. It can be concluded that a change in expression of this protein in patients' sera could be used as an indicator tool for the achievement of lungs CE surgical therapy.
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Affiliation(s)
- Fatemeh Sadat Sadjjadi
- grid.411600.2Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homa Hajjaran
- grid.411705.60000 0001 0166 0922Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Sedaghat
- grid.412571.40000 0000 8819 4698Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parviz Mardani
- grid.412571.40000 0000 8819 4698Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mahmoud Sadjjadi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Abstract
Echinococcosis is a worldwide public health problem causing considerable paediatric morbidity and mortality in endemic areas. The presentation of cystic echinococcosis (CE) varies by age. Unlike adults, where hepatic involvement is common, pulmonary CE is the dominant site in the paediatric population. Pulmonary cysts are typically first seen on chest X-ray, either as an incidental finding or following respiratory symptoms after cyst rupture or secondary infection of the cyst. In children, pulmonary cysts have a broad differential diagnosis, and a definitive diagnosis relies on the combination of imaging, serology, and histology. In countries with high infectious burdens from diseases such as acquired immunodeficiency syndrome (AIDS) and tuberculosis (TB), the diagnosis is additionally challenging, as atypical infections are more common than in developed countries. Pulmonary CE is treated with a combination of surgery and chemotherapy.
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Maamri K, Cherif I, Trifa A, Nessib N, Elkahla G, Darmoul M. Hydatid cyst in the third ventricle of the brain: case report of an exceptionally rare condition. Childs Nerv Syst 2022; 38:1637-1641. [PMID: 35137268 DOI: 10.1007/s00381-022-05460-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/17/2022] [Indexed: 12/13/2022]
Abstract
Hydatid disease is an endemic zoonotic disease caused by the cestode Echinococcus multilocularis and Echinococcus granulosus. Intra-ventricular hydatid cysts are extremely rare. Even more rarely, and to the best of our knowledge, only three cases of third ventricle involvement have been reported. Herein, we present the fourth case of an intraventricular hydatid cyst in a pediatric patient located in the third ventricle. It is about a 7-year-old girl, of a rural origin, admitted for intracranial hypertension, deterioration of the general status, and weakness on the right side of her body. A cerebral magnetic resonance imaging (MRI) showed the presence of a rounded cystic formation in the third ventricle. The patient was operated through a transfrontal transventricular approach, and the cyst was removed. Postoperative course was uneventful. Hydatid disease should be considered part of the differential diagnosis for cystic lesions of the central nervous system, especially in endemic regions. Total removal of the cysts without rupture is a challenge, but best treatment remains an active nationwide prevention.
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Affiliation(s)
- Kais Maamri
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia.
| | - Ines Cherif
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia
| | - Amine Trifa
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia
| | - Nessrine Nessib
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia
| | - Ghassen Elkahla
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia
| | - Mehdi Darmoul
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia
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Datta P, Sharma B, Peters NJ, Khurana S, Sehgal R. Bilateral Pulmonary Hydatid Cyst in a Young Child: A Rare Case Report from North India. J Lab Physicians 2022; 14:348-350. [PMID: 36119419 PMCID: PMC9473927 DOI: 10.1055/s-0042-1742420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Echinococcosis or hydatid disease is caused by the larval stage of the dog tapeworm, that is,
Echinococcus granulosus
,
E. multilocularis
,
E. vogeli
, or
E. oligarthrus
.
Echinococcus granulosus
causes cystic echinococcosis, which has a worldwide distribution. Liver is the most common site, affecting approximately two-third of the patients, whereas lung involvement is seen in approximately 25% of cases. This case is a very rare scenario of bilateral pulmonary hydatid cysts in a young child having exposure to a pet dog with negative hydatid serology and normal eosinophil count.
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Affiliation(s)
- Priya Datta
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhawna Sharma
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nitin James Peters
- Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sumeeta Khurana
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Sehgal
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Tandur R, Irodi A, Chacko BR, Vimala LR, Christopher DJ, Gnanamuthu BR. Magnetic resonance imaging as an adjunct to computed tomography in the diagnosis of pulmonary Hydatid cysts. Indian J Radiol Imaging 2021; 28:342-349. [PMID: 30319213 PMCID: PMC6176659 DOI: 10.4103/ijri.ijri_121_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction: Although pulmonary hydatid cysts can be diagnosed on computed tomography (CT), sometimes findings can be atypical. Other hypodense infective or neoplastic lesions may mimic hydatid cysts. We proposed that magnetic resonance imaging (MRI) may act as a problem-solving tool, aiding the definite diagnosis of hydatid cysts and differentiating it from its mimics. The aim of this study is to assess the findings of pulmonary hydatid cysts on CT and MRI and the additional contribution of MRI in doubtful cases. Materials and Methods: This is a retrospective study of 90 patients with suspected hydatid cysts. CT and MRI findings were noted and role of MRI in diagnosing hydatid cysts and its mimics was studied. Descriptive statistics for CT findings and sensitivity and specificity of MRI were calculated using surgery or histopathology as gold standard. Results: Of the 90 patients with suspected pulmonary hydatid cysts, there were 52 true-positive and 7 false-positive cases on CT. Commonest CT finding was unilocular thick-walled cyst. In the 26 patients who had additional MRI, based on T2-weighted hypointense rim or folded membranes, accurate preoperative differentiation of 14 patients with hydatid cysts from 10 patients with alternate diagnosis was possible. There was one false-positive and one false-negative case on MRI. Conclusion: Although hydatid cyst can be diagnosed on CT on most occasions, sometimes there are challenges with certain mimics and atypical appearances. T2-weighted MRI can act as a problem solving tool to conclusively diagnose hydatid cyst or suggest an alternate diagnosis.
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Affiliation(s)
- Roopa Tandur
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Aparna Irodi
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Binita Riya Chacko
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | | | | | - Birla Roy Gnanamuthu
- Department of Cardiothoracic Surgery, Christian Medical College, Vellore, Tamil Nadu, India
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The spectrum of imaging findings in pulmonary hydatid disease and the additive value of T2-weighted magnetic resonance imaging in its diagnosis. Pol J Radiol 2021; 86:e53-e63. [PMID: 33708273 PMCID: PMC7934737 DOI: 10.5114/pjr.2021.103237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 08/15/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose To describe the spectrum of imaging findings in pulmonary echinococcosis and to study the additive value of T2-weighted magnetic resonance imaging (MRI) in the characterisation of pulmonary hydatid disease. Material and methods This was a descriptive, prospective study conducted for a period of 3 years from December 2016 to November 2019. Patients suspected of having pulmonary echinococcosis (n = 110) on preliminary chest radiography were examined with chest computed tomography (CT). Among them 41 cases were additionally examined with T2-weighted MRI of thorax. Final diagnosis was based on surgery or histopathology. Results Of the 110 patients enrolled for the study 15 were lost to attrition, and among the final cohort of 95 patients CT correctly diagnosed 68/84 (80.9%) as hydatid cyst, whereas 16/84 (19.1%) received an erroneous alternate diagnosis on CT. Based on the classical findings of hyperintense pulmonary cystic lesion with T2-weighted hypointense rim or detached internal T2-weighted hypointense membrane, a correct diagnosis of hydatid cyst was possible in 30 patients whereas a correct alternate diagnosis was made in 8 cases. T2-weighted MRI was found to have sensitivity of 96.7%, specificity of 80%, positive predictive value (PPV) of 93.7% and negative predictive value (NPV) of 88.9% with an overall diagnostic accuracy of 92.6%. Using the McNemar test, MRI was found to be diagnostically superior to CT (p = 0.019). Conclusions Most of the pulmonary hydatid cysts can be diagnosed on CT; however, sometimes the findings may be indeterminate or atypical, leading to a diagnostic dilemma. MRI, owing to its ability to demonstrate hypointense endocyst, can act as a useful adjunct to correctly diagnose hydatid cyst or suggest an alternative diagnosis.
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Lakhdar F, Benzagmout M, Chakour K, Chaoui MEF. Multiple and infected cerebral hydatid cysts mimicking brain tumor: Unusual presentation of hydatid cyst. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2020.100802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Durhan G, Tan AA, Düzgün SA, Akkaya S, Arıyürek OM. Radiological manifestations of thoracic hydatid cysts: pulmonary and extrapulmonary findings. Insights Imaging 2020; 11:116. [PMID: 33175295 PMCID: PMC7658283 DOI: 10.1186/s13244-020-00916-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/30/2020] [Indexed: 11/27/2022] Open
Abstract
Hydatid cyst caused by the larval form of Echinococcus is a worldwide zoonosis. The lungs and liver are the most common sites involved. While the lung parenchyma is the most common site within the thorax, it may develop in any extrapulmonary region including the pleural cavity, fissures, mediastinum, heart, vascular structures, chest wall, and diaphragm. Imaging plays a pivotal role not only in the diagnosis of hydatid cyst, but also in the visualization of the extent of involvement and complications. The aim of this pictorial review was to comprehensively describe the imaging findings of thoracic hydatid cyst including pulmonary and very unusual extrapulmonary involvements. An outline is also given for the findings of complications and differential diagnosis of thoracic hydatid cyst.
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Affiliation(s)
- Gamze Durhan
- Department of Radiology, Hacettepe University Faculty of Medicine, 06410, Ankara, Turkey.
| | - Aziz Anıl Tan
- Department of Radiology, Hacettepe University Faculty of Medicine, 06410, Ankara, Turkey
| | - Selin Ardalı Düzgün
- Department of Radiology, Hacettepe University Faculty of Medicine, 06410, Ankara, Turkey
| | - Selçuk Akkaya
- Department of Radiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Orhan Macit Arıyürek
- Department of Radiology, Hacettepe University Faculty of Medicine, 06410, Ankara, Turkey
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Petropoulos AS, Chatzoulis GA. Echinococcus Granulosus in Childhood: A Retrospective Study of 187 Cases and Newer Data. Clin Pediatr (Phila) 2019; 58:864-888. [PMID: 31081377 DOI: 10.1177/0009922819847032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Echinococcus granulosus, first reported by Goeze in 1782, is the causative parasite of cystic echinococcosis (hydatidosis) especially for countries that are endemic areas. Since the 1970s, the incidence of echinococcosis in Greece has been very high. Nevertheless, with the implementation of special prevention measures in the 1980s, a large reduction in the incidence of hydatidosis meant that it reached European levels. Therefore, we analyzed the demographics, multiple organ localizations of the parasite, diagnosis, and conservative and optimal surgical treatment over a total period of 39 years, especially for pulmonary and hepatic echinococcosis in children. The higher incidence of pulmonary echinococcosis compared with other localizations, male predominance, wide range of age, and various cystic sizes were some of the main demographics. Because cystic echinococcosis remains a main public health problem, we advocate a meticulous clinical investigation and treatment methodology to bridge the gap between knowledge and awareness of this important disease.
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Affiliation(s)
- Anastasios S Petropoulos
- 1 Aristotle University of Thessaloniki, Greece and Departments of Pediatric Surgery General Hospitals of Thessaloniki, "G .Gennimatas" and "N. Papageorgiou", Thessaloniki, Greece
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Prospective Comparison of MRI and Contrast-Enhanced MDCT for Evaluation of Pediatric Pulmonary Hydatid Disease: Added Diagnostic Value of MRI. AJR Am J Roentgenol 2019; 212:982-987. [PMID: 30779656 DOI: 10.2214/ajr.18.20928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE. The objective of our study was to prospectively investigate the diagnostic accuracy and added value of fast MRI for evaluating pulmonary hydatid disease in children by comparing fast MRI findings with MDCT findings. SUBJECTS AND METHODS. Twenty-eight consecutive children (24 boys and four girls; mean age ± SD, 8.93 ± 3.1 years; range, 5-17 years) with clinically suspected pulmonary hydatid disease were enrolled in this prospective research study for the period from October 2012 to July 2018. Fast MRI without contrast material and contrast-enhanced MDCT of the chest were performed within 48 hours of each other in all children. Two pediatric radiologists independently evaluated the lungs for the presence of consolidation, nodule, and mass (solid vs cyst). Cysts were further evaluated for the presence of fluid, air, and an internal membrane. The accuracies of fast MRI and MDCT for detecting pulmonary hydatid disease were obtained and compared. Interobserver agreement was measured with the kappa coefficient. RESULTS. The accuracy of fast MRI and MDCT for detecting pulmonary hydatid cyst was 92.86%. There was no difference between fast MRI and MDCT for accurately detecting pulmonary hydatid cyst (p < 0.001). Internal membranes were detected in 11 of 28 patients (39.28%) with fast MRI and three of 28 patients (10.71%) with MDCT. Almost perfect interobserver agreement was present between the two independent reviewers (κ = 1). CONCLUSION. Fast MRI without contrast material is comparable to contrast-enhanced MDCT for accurately detecting lung cysts in pediatric patients with pulmonary hydatid disease. However, fast MRI provides added diagnostic value by showing internal membranes of cysts, which is specific to pulmonary hydatid disease.
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Zribi H, Abdelkbir A, Aouadi S, Abdennadher M, Ayadi A, Mestiri T, Marghli A. La chirurgie de l’hydatidose pulmonaire chez les enfants. Étude de 676 cas. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Akgul Ozmen C, Onat S. Computed Tomography (CT) Findings of Pulmonary Hydatid Cysts in Children and the Factors Related to Cyst Rupture. Med Sci Monit 2017; 23:3679-3686. [PMID: 28754885 PMCID: PMC5546193 DOI: 10.12659/msm.906163] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The lungs are the most common site of hydatid cysts in children. Rupture is the main complication of cysts causing morbidity and mortality. In this study we aimed to comprehensively describe the CT signs for cysts and analyze the relationship of cyst ruptures to the diameter and location of cyst. Material/Methods A total of 145 cysts from 102 patients, aged 17 years or younger, who underwent a multi-detector computed tomography (MDCT) evaluation and had surgically proven pulmonary hydatid disease were included retrospectively. The CT images were analyzed for radiologic findings and signs of cyst rupture. Results The cysts had a mean diameter of 5.45±3.03 cm. Most of the patients had a solitary cyst (70.6%). The most common lobes involved were the lower lobes (58.6%). Peripherally located cysts were more common than central cysts. The overall number of ruptured cysts was 69 (47.5%). The most common sign was the waterlily sign with a prevalence of 24.6%. After exclusion of cysts of 1 cm, the mean cyst diameter was 6.23±2.83 cm in the unruptured group and 5.02±2.80 cm in the complete ruptured group (p=0.020). The mean cyst diameter was 6.38±3.11 cm for centrally located cysts, and 4.31±2.37 cm for peripherally located cysts (p<0.0001). Conclusions Pulmonary hydatid cysts commonly presents as solitary cysts with a predilection for lower lobes and the peripheral regions of the lung. Peripherally located cysts are more common but smaller than centrally located cysts. Radiologists should also be aware of atypical imaging findings of cyst rupture, and radiologic signs should be explored during radiologic evaluation.
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Affiliation(s)
- Cihan Akgul Ozmen
- Department of Radiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Serdar Onat
- Department of Thoracic Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
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14
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Shanshan W, Hui L, Yan L, Li W, Yongfang R, Yan W, Kader M, Wenxiao J. The study of biochemical profile of cyst fluid and diffusion-weighted magnetic resonance imaging in differentiating hepatic hydatid cysts from liver simple cysts. J Clin Lab Anal 2017; 32. [PMID: 28303600 PMCID: PMC6084328 DOI: 10.1002/jcla.22192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 01/31/2017] [Indexed: 12/28/2022] Open
Abstract
Purpose The aim of this study was to investigate the value of biochemical profile of cyst fluid and diffusion‐weighted imaging (DWI) in differentiating hepatic hydatid cysts (HCs) from liver simple cysts. Materials and methods Forty‐six patients underwent MR imaging. Twenty‐nine patients had 29 hydatid cysts and 17 patients had liver simple cysts. Thirteen patients with hydatid cysts and seven patients with liver simple cysts were evaluated with cyst fluid biochemical analysis. The concentration of glucose, protein, calcium ion (Ca2+) electrolyte, macroscopic appearance, and parasitological sediment were evaluated in this study. Results In the respect of biochemical analysis cyst fluid, the concentration of glucose and calcium ion of HCs was significantly higher than that of the liver simple cysts. In the respect of DWI, in the b 1000 s/mm2 value in respect of mean application data center (ADC) values, there was a statistically significant difference between HCs group (the mean value was (2.50±0.79)×10−3 mm/s2) and liver simple cysts group (the mean value was (2.92±0.66)×10−3 mm/s2). However, no statistically significant results were obtained in the ADC measurements of b 500 s/mm2 between two groups. Conclusion The analysis of cyst fluid combined with the measurement of ADC values in the b 1000 s/mm2 value could be considered a promising parameter as an alternative to the differential diagnosis of hepatic hydatid cysts from liver simple cysts.
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Affiliation(s)
- Wang Shanshan
- Department of Radiology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.,Department of Radiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Li Hui
- Department of Radiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Liu Yan
- Department of Radiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Wang Li
- Department of Orthopaedics, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Ren Yongfang
- Department of Radiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Wang Yan
- Department of Radiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Muhetarjiang Kader
- Department of Radiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Jia Wenxiao
- Department of Radiology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
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Kern P, Menezes da Silva A, Akhan O, Müllhaupt B, Vizcaychipi KA, Budke C, Vuitton DA. The Echinococcoses: Diagnosis, Clinical Management and Burden of Disease. ADVANCES IN PARASITOLOGY 2017; 96:259-369. [PMID: 28212790 DOI: 10.1016/bs.apar.2016.09.006] [Citation(s) in RCA: 258] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The echinococcoses are chronic, parasitic diseases that are acquired after ingestion of infective taeniid tapeworm eggs from certain species of the genus Echinococcus. Cystic echinococcosis (CE) occurs worldwide, whereas, alveolar echinococcosis (AE) is restricted to the northern hemisphere, and neotropical echinococcosis (NE) has only been identified in Central and South America. Clinical manifestations and disease courses vary profoundly for the different species of Echinococcus. CE presents as small to large cysts, and has commonly been referred to as 'hydatid disease', or 'hydatidosis'. A structured stage-specific approach to CE management, based on the World Health Organization (WHO) ultrasound classification of liver cysts, is now recommended. Management options include percutaneous sterilization techniques, surgery, drug treatment, a 'watch-and-wait' approach or combinations thereof. In contrast, clinical manifestations associated with AE resemble those of a 'malignant', silently-progressing liver disease, with local tissue infiltration and metastases. Structured care is important for AE management and includes WHO staging, drug therapy and long-term follow-up for at least a decade. NE presents as polycystic or unicystic disease. Clinical characteristics resemble those of AE, and management needs to be structured accordingly. However, to date, only a few hundreds of cases have been reported in the literature. The echinococcoses are often expensive and complicated to treat, and prospective clinical studies are needed to better inform case management decisions.
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Affiliation(s)
- P Kern
- University Hospital of Ulm, Ulm, Germany
| | | | - O Akhan
- Hacettepe University, Ankara, Turkey
| | - B Müllhaupt
- University Hospital of Zurich, Zürich, Switzerland
| | - K A Vizcaychipi
- National Institute of Infectious Diseases, Buenos Aires, Argentina
| | - C Budke
- Texas A&M University, College Station, TX, United States
| | - D A Vuitton
- Université de Franche-Comté, Besançon, France
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16
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Garg MK, Sharma M, Gulati A, Gorsi U, Aggarwal AN, Agarwal R, Khandelwal N. Imaging in pulmonary hydatid cysts. World J Radiol 2016; 8:581-587. [PMID: 27358685 PMCID: PMC4919757 DOI: 10.4329/wjr.v8.i6.581] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 11/23/2015] [Accepted: 03/23/2016] [Indexed: 02/06/2023] Open
Abstract
Hydatid disease is a zoonosis that can involve almost any organ in the human body. After the liver, the lungs are the most common site for hydatid disease in adults. Imaging plays a pivotal role in the diagnosis of the disease, as clinical features are often nonspecific. Classical radiological signs of pulmonary hydatid cysts have been described in the literature, aiding in the diagnosis of the disease. However, complicated hydatid cysts can prove to be a diagnostic challenge at times due to their atypical imaging features. Radiography is the initial imaging modality. Computed tomography can provide a specific diagnosis in complicated cases. Ultrasound is particularly useful in peripheral lung lesions. The role of magnetic resonance imaging largely remains unexplored.
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Abstract
Cystic echinococcosis (CE) is a zoonotic parasitic disease caused by the larval stages of the cestode Echinococcus granulosus. Worldwide, pulmonary hydatid cyst is a significant problem medically, socially, and economically. Surgery is the definitive therapy of pulmonary hydatidosis. Benzimidazoles may be considered in patients with a surgical contraindication. This review will focus on pathogenesis, lifecycle, clinical features, and management of pulmonary hydatid disease.
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Affiliation(s)
- Malay Sarkar
- Department of Pulmonary Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Rajnish Pathania
- Department of Cardiac and Thoracic Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Anupam Jhobta
- Department of Radiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Babu Ram Thakur
- Department of Cardiac and Thoracic Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Rajesh Chopra
- Department of Cardiac and Thoracic Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
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Pandey S, Pandey D, Shende N, Sahu A, Sharma V. Cerebral intraventricular echinococcosis in an adult. Surg Neurol Int 2015; 6:138. [PMID: 26392915 PMCID: PMC4553664 DOI: 10.4103/2152-7806.163177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 05/31/2015] [Indexed: 11/29/2022] Open
Abstract
Background: Echinococcosis in humans occurs as a result of infection by the larval stages of taeniid cestodes of the genus echinococcus. Intracranial hydatid cysts usually develop at an intraparenchymal site. Hydatid cyst within the cerebral ventricle is quite unusual. Methods: We reviewed the literature on adult intraventricular hydatid cyst and found case reports mainly in children with an only handful of cases in adults. We reported a rare case of cerebral intraventricular (left lateral ventricle) hydatid cyst in a 21-year-old adult female. Results: Although cerebral hydatid cysts are most commonly seen in children and young adults cerebral intraventricular hydatid cyst are comparatively rarer in adults. Conclusion: The possibility of infection with Echinococcus granulosus should be included in the differential diagnosis of raised intracranial hypertension in patients from endemic areas.
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Affiliation(s)
- Sharad Pandey
- Department of Neurosurgery, Sir Sunderlal Hospital, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Deepa Pandey
- Department Clinical Microbiology, DLW, Varanasi, Uttar Pradesh, India
| | - Neeraj Shende
- Department of Neurosurgery, Sir Sunderlal Hospital, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Anurag Sahu
- Department of Neurosurgery, Sir Sunderlal Hospital, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Vivek Sharma
- Department of Neurosurgery, Sir Sunderlal Hospital, IMS, BHU, Varanasi, Uttar Pradesh, India
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Surgical treatment of pulmonary hydatidosis: a single-centre experience of four years. Indian J Thorac Cardiovasc Surg 2014. [DOI: 10.1007/s12055-014-0315-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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20
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Imaging features of cerebral and spinal cystic echinococcosis. Radiol Med 2014; 120:458-65. [DOI: 10.1007/s11547-014-0475-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 06/11/2014] [Indexed: 12/28/2022]
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21
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Hydatid disease located in the cerebellomedullary cistern. Case Rep Med 2014; 2014:271365. [PMID: 24782895 PMCID: PMC3982244 DOI: 10.1155/2014/271365] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 02/18/2014] [Indexed: 11/17/2022] Open
Abstract
Hydatid disease is an endemic zoonotic disease in many areas of the world. Liver, followed by lung, is the most commonly affected organ and involvement of other organs is rare. When brain is involved, lesions are typically supratentorial, and infratentorial localisation is even rarer. We present a 45-year-old woman with hydatid disease located in premedullary location compressing the brain stem, an exceedingly rare location for cerebral echinococcosis. Relevant literature regarding typical properties of cerebral disease was reviewed.
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Odev K, Guler I, Altinok T, Pekcan S, Batur A, Ozbiner H. Cystic and cavitary lung lesions in children: radiologic findings with pathologic correlation. J Clin Imaging Sci 2013; 3:60. [PMID: 24605255 PMCID: PMC3935260 DOI: 10.4103/2156-7514.124087] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 10/11/2013] [Indexed: 11/04/2022] Open
Abstract
A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containing cysts or cavitary lung lesions in both infants and children. In infants and children, there is a spectrum of focal or multifocal cystic and cavitary lung lesions including congenital lobar emphysema, congenital cystic adenomatoid malformation, pleuropulmonary blastoma, bronchogenic cyst, pulmonary sequestration, Langerhans cell histiocytosis, airway diseases, infectious diseases (bacterial infection, fungal infection, etc.), hydatid cysts, destroid lung, and traumatic pseudocyst. For the evaluation of cystic or cavitary lung lesion in infants and children, imaging plays an important role in accurate early diagnosis and optimal patient management. Therefore, a practical imaging approach based on the most sensitive and least invasive imaging modality in an efficient and cost-effective manner is paramount. We reviewed the conventional radiographs and computed tomography findings of the most common cystic and cavitary lung lesions in infants and children.
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Affiliation(s)
- Kemal Odev
- Department of Radiology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Ibrahim Guler
- Department of Radiology, Konya Research and Education Hospital, Konya, Turkey
| | - Tamer Altinok
- Department of Thoracic Surgery, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Sevgi Pekcan
- Department of Pediatric Chest Diseases, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Abdussamed Batur
- Department of Radiology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Hüseyin Ozbiner
- Department of Radiology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
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Jayakumar PN, Chandrashekar HS, Ellika S. Imaging of parasitic infections of the central nervous system. HANDBOOK OF CLINICAL NEUROLOGY 2013; 114:37-64. [PMID: 23829900 DOI: 10.1016/b978-0-444-53490-3.00004-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Parasitic infections of the central nervous system (CNS) have increased over the last couple of decades, partly due to a drop in the living conditions of large populations in the world and the AIDS epidemic. Parasitic infections of the CNS are indolent and often life threatening, hence, an early diagnosis is imperative. While brain biopsy and laboratory analysis remain the gold standard for diagnosis, neuroimaging contributes significantly to diagnosis and follow-up. Imaging can demonstrate the extent of infection and complications and possibly, the type of parasitic infection when characteristic features are evident. The disappearance of the parasite or inflammation, gliosis, and/or calcification suggest a therapeutic response. The initial experience of the CT scan has been greatly enhanced by MRI which is currently the imaging modality of choice. This has been due to the greater tissue contrast resolution of MRI and its ability to detect subtle changes in the tissue parenchyma. Advanced techniques such as diffusion-weighted imaging (DWI), perfusion imaging (PI), MR angiography (MRA), and MR spectroscopy (MRS) have been used to improve the sensitivity for characterizing the type, viability, and burden of the parasites and the host tissue response. Additionally, it is possible to demonstrate the complications of the primary infection and those secondary to treatment, in some cases.
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Mohindra S, Savardekar A, Gupta R, Tripathi M, Rane S. Varied types of intracranial hydatid cysts: radiological features and management techniques. Acta Neurochir (Wien) 2012; 154:165-72. [PMID: 21969224 DOI: 10.1007/s00701-011-1181-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 09/20/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND Even when radiological images are considered pathognomic for intracranial hydatid cysts, subtle image characteristics are evident depending upon the status/types of hydatid cysts. These imaging features, if finely scrutinized, may help to modify conventional surgical techniques of cyst excision. METHODS From January 2006 to December 2011, nine patients (male:female 7:2, age range 4-44 years, median 7 years) harbouring intracranial hydatid cysts were managed at our centre. In addition to CT scans, all patients underwent plain and contrast-enhanced MRI scans. Based on these radiological findings, the types of hydatid cysts were characterized into simple or complicated (infected) cysts. Complicated cysts were further differentiated into ruptured or intact subtypes based on imaging features. Surgical procedures including the Dowling water dissection technique, in addition to head rotation, were performed for removing these cysts intact. RESULTS Children (n = 4) aged 6 years or less presented with increasing head size as the only complaint, while the rest of the patients (n = 5) had symptoms of raised intracranial pressure. MRI features of hypo-intensity on T1-weighted images, hyper-intensity on T2-weighted images, and non-contrast-enhancing cysts were noted for all simple cysts (n = 7), while iso- to mixed intensity on T1-weighted images and hyper-intensity on T2-weighted images with contrast-enhancing pericyst correctly diagnosed all complicated (infected) hydatid cysts (n = 2). One of these complicated cysts had spilled the infected contents outside the cyst wall, but within the confines of the cerebral parenchyma (pericyst). Such a case of contained spontaneously ruptured complicated hydatid cyst is described for the first time. At a median follow-up of 18 months, all patients remain free from cyst recurrence. CONCLUSION Subtle changes in radiological features of CNS hydatid cysts should be appreciated so as to diagnose the type of cyst correctly. The surgical strategy should be tailored according to the type of cyst for favourable outcome.
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Affiliation(s)
- Sandeep Mohindra
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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25
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Karamustafaoglu YA, Reyhan G, Kuzucuoglu M, Yoruk Y. One-stage surgical management for lung and liver hydatid diseases. Eur Surg 2011. [DOI: 10.1007/s10353-011-0002-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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26
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Primary spinal hydatid cyst in a patient with acquired immunodeficiency syndrome. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2010; 20 Suppl 2:S235-8. [PMID: 21069542 DOI: 10.1007/s00586-010-1614-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 09/25/2010] [Accepted: 10/20/2010] [Indexed: 10/18/2022]
Abstract
Spinal hydatid cyst is a serious and unusual infectious disease. There is little information on infections caused by cestodes in patients with human immunodeficiency virus (HIV) infection. Although infrequent, infections by cestodes constitute a cause of disease in HIV-infected patients, especially in endemic areas. This report presents, for the first time in the literature, primary spinal cyst hydatid in a patient with acquired immunodeficiency syndrome.
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Kerimoglu U, Kapicioglu S, Emlik D, Arazi M, Ural O. Case 161: hydatid disease with water lily sign manifesting as a soft-tissue mass in the calf of a child. Radiology 2010; 256:1007-10. [PMID: 20720081 DOI: 10.1148/radiol.10081066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ulku Kerimoglu
- Department of Radiology, Selcuk University, Meram School of Medicine, Meram, Konya, Turkey.
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Kavukcu S, Kilic D, Tokat AO, Kutlay H, Cangir AK, Enon S, Okten I, Ozdemir N, Gungor A, Akal M, Akay H. Parenchyma-Preserving Surgery in the Management of Pulmonary Hydatid Cysts. J INVEST SURG 2009; 19:61-8. [PMID: 16546931 DOI: 10.1080/08941930500444586] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Pulmonary hydatid cysts remain a significant health problem in endemic regions like Turkey. Here, we present our surgical experience in patients with pulmonary hydatid cysts. Between January 1985 and January 2001, 1118 operations were performed in 1032 patients (528 males, 504 females; mean age 32.7 years; range 1-87 years) with pulmonary hydatid cysts in our department. Posterolateral thoracotomy was performed in 1015 (98.3%), two-stage thoracotomy in 34 (3.3%), and median sternotomy in 17 (1.7%) patients. We preferred conservative surgical procedures. As a surgical procedure, cystotomy and capitonnage was performed in 626 (56%), cystotomy alone in 368 (33%), wedge resection in 81 (7%), enucleation in 29 (3%), and decortication in 11 (1%) patients. None of our patients were treated with anatomic resection. During surgery, 949 patients (92%) had unruptured and 83 patients (8%) had ruptured hydatid cyst. The morbidity ratio was 6.7%. Major complications were wound infection (2.3%), prolonged air leak (1.9%), atelectasis (1.2%), pleural effusion (0.8%), postoperative hemothorax (0.6%), and empyema (0.3%). Two patients (0.2%) died within the first month postoperatively. Mean follow-up was 31.2 months. Recurrence was detected in only 35 patients (3.3%). Treatment of pulmonary hydatid cyst is primarily surgical. Medical treatment is indicated for recurrent and multiple hydatid cysts postoperatively. Cystotomy alone, or cystotomy and capitonnage, as parenchyma-preserving surgery, is preferred. Radical surgery including pneumonectomy, lobectomy, and segmentectomy should be avoided.
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Affiliation(s)
- Sevket Kavukcu
- Department of Thoracic Surgery, Ankara University, School of Medicine, Ankara, Turkey
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Experience with video-assisted thoracoscopic removal of pulmonary hydatid cysts in children. J Pediatr Surg 2009; 44:836-41. [PMID: 19361650 DOI: 10.1016/j.jpedsurg.2008.11.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2008] [Revised: 11/03/2008] [Accepted: 11/05/2008] [Indexed: 11/24/2022]
Abstract
Pulmonary hydatid disease is prevalent in many parts of world including India. In our small series of 5 pediatric patients, all patients were diagnosed with clinical and radiological findings on plain X-ray chest and CT (Computed Tomography) chest. All of them received oral albendazole 10 mg/kg/day soon after diagnosis except in one patient in which preoperative differential diagnosis was bronchogenic cyst and lung abscess (case 4). All underwent video assisted thoracoscopy. Simple endotracheal intubation was utilized in all cases along with CO(2) insufflation. Complete thoracoscopic removal was successful in 3 cases, while conversion to open thoracotomy was required in 2 cases. All of them showed rapid recovery except for one patient in whom prolonged intercostal drainage was present for 2 weeks. The average duration of procedure was 150 minutes and average length of hospital stay was 4.5 days except case 2, which was discharged on day 15 due to prolonged air leak. Histopathology in all cases was suggestive of hydatid cyst. At mean follow up of 6 months, all patients are asymptomatic and doing well.
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30
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Acer T, Karnak I, Haliloglu M, Ekinci S, Senocak ME. Spontaneous expulsion of intact germinative membrane of liver hydatid cyst in a child. J Pediatr Surg 2008; 43:e23-5. [PMID: 18639670 DOI: 10.1016/j.jpedsurg.2008.03.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 03/05/2008] [Accepted: 03/10/2008] [Indexed: 11/17/2022]
Abstract
A 10-year-old girl presented with an acute abdomen because of spontaneous rupture of a liver hydatid cyst (HC) and associated pelvic cystic mass. The pelvic cyst was found to be an intact germinative membrane of the ruptured HC of the liver at operation. This is the first pediatric case presenting with expulsion of an intact germinative membrane of a spontaneously ruptured HC. Intact germinative membrane should be included in the differential diagnosis of intraabdominal and pelvic cystic masses in children. The liver should be evaluated for ruptured cyst, and the lungs should also be evaluated to detect accompanying pulmonary hydatid disease (HD) especially in children living in countries in which the HD is endemic.
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Affiliation(s)
- Tuğba Acer
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, 06100 Sihhiye, Ankara, Turkey
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Abstract
Hydatid disease, caused by Echinococcus granulosus, is a parasitic disease that is endemic in many parts of the world. Hydatid cyst demonstrates a variety of imaging features, varying according to growth stage, associated complications, and affected tissue. The radiologic findings range from purely cystic lesions to a completely solid appearance. Ultrasound is the most important imaging modality for liver hydatid disease and clearly demonstrates the floating membranes, daughter cysts, and hydatid sand characteristically seen in purely cystic lesions. The radiologist's familiarity with the imaging findings of the disease is very important for earlier diagnosis and an appropriate treatment. There are several classification schemes for liver hydatid cysts based on their ultrasound appearances; the initial classification by Gharbi et al and the World Health Organization classification are the most commonly preferred. Computed tomography and magnetic resonance imaging play a key role in recognizing the complications such as rupture and infection of cysts associated with hydatid disease. Today, percutaneous treatment of liver hydatid cysts, a safe, easily applicable, and well-tolerated method, has become the most effective and reliable treatment procedure in most cases if the hydatid cyst is viable. In patients treated with the percutaneous treatment technique, a decrease in the dimensions of the cyst, solidification of the cyst contents, and irregularity in the walls of cysts are signs suggestive of cure. The radiologist should also be familiar with the postoperative follow-up ultrasound findings of hydatid cyst to prevent misinterpretation of the hypoechoic, anechoic, or hyperechoic appearance of posttreatment hydatid disease appearance as recurrence.
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Akhan O, Gumus B, Akinci D, Karcaaltincaba M, Ozmen M. Diagnosis and percutaneous treatment of soft-tissue hydatid cysts. Cardiovasc Intervent Radiol 2007; 30:419-25. [PMID: 17295079 DOI: 10.1007/s00270-006-0153-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The purpose of this study is to demonstrate and discuss the radiological features of four patients with muscular hydatid disease and to evaluate the results of percutaneous treatment in these patients. Four patients (three female and one male) with six muscular hydatid cysts underwent percutaneous treatment and were followed up. The mean age of patients was 35 years (range: 12-60 years). Type I (n = 2), type II (n = 1), and type III (n = 3) hydatid cysts were observed in the thigh (n = 3) and gluteal (n = 1) region on radiologic examination. All interventions were performed under sonographic and fluoroscopic guidance. According to the type of the cyst, the procedure was carried out by either a "catheterization technique with hypertonic saline and alcohol" or a "modified catheterization technique." The mean cathaterization time was 13.7 days, ranging from 1 to 54 days. The dimensions of the residual cavity were noted at every sonographic control, and an average of 96.1% volume reduction was obtained in six cysts of four patients. No sign of viability was observed during the follow-up period. Cavity infection and cellulitis were observed as complications, which resolved after medical therapy. Percutaneous treatment is a safe and effective procedure in patients with soft-tissue hydatid cysts and should be considered as a serious alternative to surgery.
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Affiliation(s)
- Okan Akhan
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.
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Abstract
Early and non-invasive evaluation of hydatid infestation of brain and spine is of paramount importance, especially in endemic areas. We present a spectrum of imaging findings in neurohydatidosis with a brief review of literature.
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Affiliation(s)
- J M E Kovoor
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
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Goktay AY, Secil M, Gulcu A, Hosgor M, Karaca I, Olguner M, Akgur FM, Dicle O. Percutaneous Treatment of Hydatid Liver Cysts in Children as a Primary Treatment: Long-term Results. J Vasc Interv Radiol 2005; 16:831-9. [PMID: 15947047 DOI: 10.1097/01.rvi.0000157777.33273.3b] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate the effectiveness and long-term results of percutaneous treatment for hydatid liver cysts in pediatric patients. MATERIALS AND METHODS Thirty-four pediatric patients (15 male, 19 female; ages 4-17 years; mean age, 9.4 years) with 51 hydatid liver cysts underwent ultrasound (US)-guided percutaneous treatment with albendazole prophylaxis. There were 15 type II lesions with membrane detachment and 36 type I lesions resembling simple hepatic cysts with pure anechogenic content or small echogenic reflections and a regular well-delineated wall. The method of US-guided puncture, aspiration, injection of hypertonic saline solution, and reaspiration was preferred for 21 lesions. For the remaining 30 larger cysts, the intervention was performed with the same percutaneous technique but followed by catheterization, drainage, control cystography, and sclerotherapy with ethanol. During follow-up, US examinations were performed at 1, 3, 6, and 12 months for the first year and yearly thereafter. RESULTS Percutaneous treatment of hepatic hydatid disease was successful in 33 patients (97.1%). During follow-up, US findings in the lesions changed significantly; at year 1, the inner content of the lesions became heterogeneous with a semisolid appearance, and the mean reduction in volume was 81.4%. At 2-year follow-up, most hydatid cysts had become solid in nature and the reduction in volume reached 65%-99% (mean, 85.1%). There were no recurrences or additional lesions after the follow-up of 1-6 years (mean, 3.1 years). Average hospital stay for the whole group in this study was 3.5 days. CONCLUSIONS The long-term results of percutaneous liver hydatid cyst treatment in children are in accordance with the results in adults. Percutaneous treatment of uncomplicated type I and type II liver hydatid cysts in pediatric patients is an efficient and safe treatment with short hospitalization.
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Erdoğmus B, Yazıcı, B, Özdere BA. MAGNETIC RESONANCE IMAGING OF PRIMARY INTRADURAL-EXTRAMEDULLARY THORACOLUMBAR HYDATID CYST. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2005. [DOI: 10.29333/ejgm/82276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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36
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Abstract
A 12-year-old girl presented with hemoptysis, fever and weight loss. She was initially diagnosed and treated for presumed tuberculosis and a lung abscess. Salmonella typhi was isolated from the abscess. Hydatid cyst was diagnosed at surgery. This is the first reported case of a pulmonary hydatid cyst infected with S. typhi.
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Affiliation(s)
- Fawad Aslam
- Aga Khan University Medical College, The Aga Khan University Hospital, Karachi, Pakistan
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Abstract
Hydatid disease is a common zoonosis caused by the larval cysts of Echinococcus granulosus (parasitic tapeworm). In children, lung hydatid cysts are more common than liver cysts, whereas in adults the reverse is true. Pulmonary hydatids can be accompanied by concurrent liver cysts. Leakage or rupture of a hydatid cyst can cause allergic reactions including anaphylaxis. Albendazole is effective therapy either alone or as an adjunct to surgery.
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Affiliation(s)
- L Teoh
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
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38
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Biswas B, Ghosh D, Bhattacharjee R, Patra A, Basuthakur S, Basu R. One stage surgical management of hydatid cyst of lung & liver—by right thoracotomy & phrenotomy. Indian J Thorac Cardiovasc Surg 2004. [DOI: 10.1007/s12055-004-0048-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Kodama Y, Fujita N, Shimizu T, Endo H, Nambu T, Sato N, Todo S, Miyasaka K. Alveolar echinococcosis: MR findings in the liver. Radiology 2003; 228:172-7. [PMID: 12750459 DOI: 10.1148/radiol.2281020323] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To clarify the magnetic resonance (MR) imaging findings of alveolar echinococcosis in the liver. MATERIALS AND METHODS Thirty-five patients with 50 lesions histologically proven to be alveolar echinococcosis were evaluated with MR imaging. Lesions were assessed with regard to the distribution pattern of solid and cystic components and pattern of contrast material enhancement. RESULTS Cystic components exhibited two patterns at T2-weighted MR imaging: small round cysts and large and/or irregular cysts. Forty-eight lesions (96%) contained small round cysts. Twenty-six lesions (52%) had large and/or irregular cysts. Forty-five lesions (90%) were associated with a solid component. MR imaging characteristics were categorized into five types: multiple small round cysts without a solid component (two lesions [4%], type 1), multiple small round cysts with a solid component (20 lesions [40%], type 2), a solid component surrounding large and/or irregular cysts with multiple small rounds cysts (23 lesions [46%], type 3), a solid component without cysts (two lesions [4%], type 4), and a large cyst without a solid component (three lesions [6%], type 5). In most cases (97%), contrast enhancement was weak. CONCLUSION The MR findings of alveolar echinococcosis in the liver are multiple small round cysts with a weakly enhanced solid component. The cystic component can be a large and/or irregular lesion, and such lesions are depicted clearly at T2-weighted MR imaging.
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Affiliation(s)
- Yoshihisa Kodama
- Department of Radiology and First Department of Surgery, Hokkaido University School of Medicine, N15, W7, Kitaku, Sapporo, 060-8638, Japan.
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Erdem CZ, Erdem LO. Radiological characteristics of pulmonary hydatid disease in children: less common radiological appearances. Eur J Radiol 2003; 45:123-8. [PMID: 12536091 DOI: 10.1016/s0720-048x(02)00054-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate the chest roentgenogram and CT characteristics of pulmonary hydatid disease (PHD). MATERIAL AND METHODS Forty-seven (27 male and 20 female, aged between 3 and 11 years) consecutive pediatric patients with surgically proven pulmonary hydatid cysts were enrolled for the study. Posteroanterior and lateral chest roentgenograms, CT of the chest, and laboratory findings (latex agglutination, Casoni skin test, and eosinophil count) were obtained from all of the patients. The radiological features (localization, internal architecture, number, diameter) were determined. RESULTS On CT examination, a total of 79 cysts were determined. On chest roentgenogram, 57 of 79 cysts were detected in all patients. Single cysts were seen in 33 patients, while multiple cysts were seen in 14. Median CT density of the cysts was 21 Hounsfield units (HU) (0-80). There were six giant cysts (>10 cm of cyst diameter). The crescent sign, water lily sign, and air-fluid level were seen in two, five and eight of the cysts, respectively. Apart from the classically described features of pulmonary hydatid cysts of the lung, a crescent-shaped rim of air at the lower end of the cyst (inverse crescent sign) was detected in three cysts. All of the liquid content of the cyst was expelled to the bronchial system (dry cyst sign) was observed in seven cysts. There were two infected cysts. Heavily calcified curvilinear cyst wall was present in one cyst. Pericystic reaction in the lung tissue was observed in five patients. Other features included pleural effusion (n=2), mediastinal shift (n=6) and atelectasis (n=7). CONCLUSIONS Chest roentgenogram is helpful for diagnosis of intact cysts but, it is impossible to define entire morphology of the complicated cysts. CT imaging recognize certain details of the lesions and discover others that are not visible by conventional radiography. In conclusion, CT examination should be done to elucidate cystic nature of the lung mass and for accurate localization in the preoperative period. In addition, inverse crescent sign should be recognized as feature of pulmonary hydatid cysts on CT.
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Affiliation(s)
- C Zuhal Erdem
- Department of Radiology, School of Medicine, Zonguldak Karaelmas University, 67600 Kozlu/Zonguldak, Turkey.
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Sivrikoz MC, Tunçözgür B, Nacak I, Elbeyli L. Surgical treatment of pulmonary hydatid cysts in pediatric patients. Pediatr Pulmonol 2003; 35:87-90. [PMID: 12526068 DOI: 10.1002/ppul.10203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Hydatid cyst is a zoonotic infection that is caused by Echinococcus granulosus and alveolaris, and that can result in endemics in rural regions. Infections caused by Echinococcus granulosus are more commonly seen in our country. In this retrospective study, we aimed at discussing the experience we have accumulated on pediatric pulmonary hydatid cyst cases over the last 6 years. Between 1995-2001, in the Department of Thoracic and Cardiovascular Surgery in Gaziantep University, 38 cases underwent 39 operations due to pulmonary and hepatic hydatid cysts. Of these, 24 were males and 14 were females, with an age range of 2-16 years. Operations were frequently performed via thoracotomy. Nineteen cysts were intact, and 26 were perforated. One case had sternotomy, another had sequential thoracotomy, and the rest of the cases underwent thoracotomy, which resulted in cystotomy-capitonnage. In the postoperative period, 2 patients had sustained air leakage, and 2 other cases developed skin infections. Average hospital stay was 5 days. After the operation, the patients received chemotherapy (albendazole 10 mg/kg/day) for 1.5 months. Early or late deaths or recurrences were not observed. We conclude that cystotomy-capitonnage is a successful treatment for pediatric pulmonary hydatid cysts, as it preserves the parenchyma. Chemotherapy in the postoperative period is beneficial in preventing the recurrences.
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Affiliation(s)
- M Cumhur Sivrikoz
- Gaziantep University School of Medicine, Department of Thoracic and Cardiovascular Surgery, Gaziantep, Turkey.
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Abstract
Echinococcosis is a zoonotic infection caused by Echinococcus spp. and is one of the most important helminthic diseases worldwide. Two forms of echinococcosis occur in Turkey, i.e. Echinococcus granulosus and E. multilocularis. The life cycle of E. granulosus is predominantly in dogs and sheep, and most sheep farmers in Turkey keep a dog or two. Stray dogs are numerous and prevention or treatment of infection in these dogs is very difficult. Cystic echinococcosis (CE) occurs throughout Turkey whereas alveolar echinococcosis (AE) predominantly occurs in the eastern Anatolian region of the country. Both CE and AE are known to be endemic but few surveys have been performed. Most data on human CE and AE have been collected from hospital records. The first reference of echinococcosis, "Kyste hydatique multiloculaire", in Turkey dates as far back to 1872 by an Ottoman Physician, C.R. Katibian. The results of the first Turkish study on E. granulosus were published in 1928. According to Ministry of Health records, 21303 patients had operations to treat or confirm CE in the period 1987-1994 which corresponds to approximately 2663 patients per year. The estimated surgical case rate of CE is 0.87-6.6 per 100000 in Turkey. The prevalence of E. granulosus infection in dogs in Turkey is between 0.32 and 40% and varies widely with geographical location. The reported prevalence of CE in domestic animals in Turkey has ranged from 11.2 to 50.7% and has varied widely with geographical location. Although no detailed information has been published on AE in domestic and wild animals in Turkey, the main definitive and intermediate hosts of E. multilocularis are assumed to be rodents and red foxes, respectively. However, there has been only a single published report of E. multilocularis in a wild animal (fox) in the northwest in 1965 by Merdivenci. The first human case of AE in Turkey was reported by Mutlu in 1939, and total cumulative reported case number is 202 between 1980 and 1998.
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Affiliation(s)
- Nazmiye Altintas
- Department of Parasitology, School of Medicine, Ege University, Bornova, Izmir, Turkey.
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Kurul IC, Topcu S, Altinok T, Yazici U, Tastepe I, Kaya S, Cetin G. One-stage operation for hydatid disease of lung and liver: principles of treatment. J Thorac Cardiovasc Surg 2002; 124:1212-5. [PMID: 12447189 DOI: 10.1067/mtc.2002.127314] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Hydatid disease is endemic in many countries throughout the world. Although we do not have exact figures, the disease is prevalent in Turkey. A considerable number of patients have additional liver cysts as well. In this study we reviewed our experience with hydatid disease of the lung and liver and discussed the principles of treatment. METHODS From 1971 to 1999, 2509 patients with pulmonary hydatidosis were referred to us, and 485 of them had concomitant liver cysts. Of these, 405 patients had cysts located on the dome of the liver, and they were operated on with phrenotomy through a right thoracotomy. Eighty patients who were found to have concomitant liver cysts in the lower part of the liver were referred to general surgery for a laparotomy. RESULTS Hydatid cysts located in the lungs were managed by means of cystotomy and capitonnage. For liver cysts, cystotomy and inversion of the cavity with sutures was the surgical method of choice, and a drain was left in place. In case of multiple cysts in the liver, needle aspiration was preferred. Twelve major complications, including excessive biliary drainage and bronchobiliary fistula, occurred in these patients. CONCLUSIONS We believe that management of pulmonary and hepatic cysts simultaneously through the thoracic route is convenient and should be encouraged in patients because this prevents a second operation. Needle aspiration can be applied only for liver cysts. It is absolutely contraindicated in lung hydatid cysts.
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Affiliation(s)
- Ismail Cüneyt Kurul
- Department of Thoracic Surgery, Atatürk Center for Chest Disease and Thoracic Surgery, Ankara, Turkey.
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Abstract
In this study, we reviewed the computed tomography (CT, n=9) and magnetic resonance (MR, n=5) imaging findings of 11 patients with pathologically confirmed cerebral hydatid disease. Among our patients, there were 10 cases of Echinococcus granulosus and 1 case of Echinococcus multilocularis. Common CT and MR imaging findings of E. granulosus lesions were well-defined, smooth thin-walled, spherical, homogeneous cystic lesions with no contrast enhancement, no calcification, and no surrounding edema. E. multilocularis lesions showed calcified round, solid pattern with definite margins, contrast enhancement, and surrounding edema.
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Affiliation(s)
- Meriç Tüzün
- Department of Radiology, Social Security Hospital, Dişkapi, Ankara 06110, Turkey.
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Tüzün M, Hekimoğlu B. Pictorial essay. Various locations of cystic and alveolar hydatid disease: CT appearances. J Comput Assist Tomogr 2001; 25:81-7. [PMID: 11176298 DOI: 10.1097/00004728-200101000-00014] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hydatid disease (echinococcosis) is a parasitic infection caused by the larval stage of the tapeworm Echinococcus. In humans, the two main forms are cystic hydatid disease, caused by E. granulosus, and less frequently alveolar hydatid disease, caused by E. multilocularis. They can be found in various sites in the body. The purpose of this essay is to illustrate the CT appearances of cystic and alveolar hydatid disease in various locations.
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Affiliation(s)
- M Tüzün
- Department of Radiology, Social Security Hospital, Ankara, Turkey.
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Topçu S, Kurul IC, Taştepe I, Bozkurt D, Gülhan E, Cetin G. Surgical treatment of pulmonary hydatid cysts in children. J Thorac Cardiovasc Surg 2000; 120:1097-101. [PMID: 11088032 DOI: 10.1067/mtc.2000.110181] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Hydatid disease is a parasitosis and endemic in many sheepraising areas; it is still an important health problem in Turkey. We report our experience with childhood hydatid cyst and discuss the concepts of treatment. METHODS The clinical courses of 128 children with thoracic and liver hydatid cyst operated on from 1994 to 2000 were reviewed. The group consisted of 71 boys and 57 girls aged from 8 months to 16 years. Intact cysts were found in 144 patients and ruptured cysts in 68. RESULTS In the postoperative course we have encountered 20 perioperative complications in 16 patients. The most common complication was residual pleural space and delayed air leakage, which occurred in 9 patients. There was no early death. CONCLUSION Surgery is the treatment of choice for most patients with pulmonary hydatid disease. The aim of surgery is evacuation of the cyst, removal of the endocyst, and management of the residual cavity. Conservative surgical methods that preserve lung parenchyma should be preferred.
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Affiliation(s)
- S Topçu
- Department of Thoracic Surgery, Atatürk Center for Chest Disease and Thoracic Surgery, Ankara, Turkey
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