Two cases of primary splenic hydatid cyst in Greece.

Cystic disease of the spleen is an uncommon entity in general population. Most cases result from parasitic infection by Echinococcus granulosus, a form called splenic hydatid disease (SHD), with a reported frequency of 0.5-6.0% within abdominal hydatidosis. On the contrary, an isolated splenic involvement of hydatid disease is very uncommon even in endemic regions. Two cases of primary SHD managed with open and laparoscopic radical surgery in our department are reported herein. Primary SHD is a rare entity with non-specific symptoms underlying clinical suspicion by the physician for prompt diagnosis. Surgical treatment is the mainstay therapy, while laparoscopic approach when feasible is safe, offering the advantages of laparoscopic surgery.

Myocardial involvement during ischemia-induced acute liver failure in the pig.

OBJECTIVE: The objective of this experimental study was to investigate a possible myocardial involvement in acute liver failure. MATERIALS AND METHODS: A porcine model of acute liver failure induced by hepatic devascularization was used. Twenty animals were allocated to the Acute Liver Failure (ALF) or Control Group (CG). Serum cardiac troponin I (cTnI), MB isoenzyme of creatine kinase (CK-MB), and also hemodynamic variables were measured and compared before surgery (T1), at 4 hr (T2), and at 7 hr (T3) after the end of surgery. RESULTS: Data from 10 pigs in the ALF and 7 in the CG were analyzed. In the ALF group, cTnI increased from 0.3 ± 0.055 to 0.35 ± 0.696 and 0.39 ± 0.06 ng/ml at T1, T2, and T3 time points, respectively (p < .001). In the CG, cTnI was not significantly changed from 0.29 ± 0.07, to 0.31 ± 0.01, and 0.31 ± 0.11 ng/ml at T1, T2, and T3 time points, respectively (p = .895). A statistically significant difference was found in cTnI between the groups at T3 (z = -2.93, p = .002). CK-MB increased significantly in both groups: in ALF group, CK-MB changed from 3.43 ± 0.53 to 4.33 ± 0.73 and 7.14 ± 1.12 ng/ml at T1, T2, and T3 time points, respectively (p < .001). In the CG, CK-MB changed from 3.6 ± 0.597 to 4.6 ± 1.07 and 6.2 ± 1.17 ng/ml at T1, T2, and T3 time points, respectively, (p = .001). Mean arterial pressure (MAP) was significantly reduced in the ALF group. CONCLUSIONS: In a porcine model of acute liver failure, a significant increase of cTnI serum levels was found, indicating that a subclinical myocardial damage may occur as a result of heart involvement in the multiple organ dysfunction.