Traumatic rupture of liver hydatid cysts into the peritoneal cavity of an 11-year-old boy: a case report from Iran

Abstract This is the first published case report of an 11-year-old patient with a rupture of a liver hydatid cyst (HC) into the peritoneal cavity after an abdominal trauma in Iran. The disease was diagnosed using focused abdominal sonography for trauma. To date, no cases of traumatic ruptures of liver HCs in children have been reported in Iran. In the endemic regions of the world, where patients suffer from a history of trauma and constant abdominal symptoms or anaphylactic shock, early diagnosis of HC is crucial as it may disseminate to other organs. The condition needs conservative surgery and follow-up.

Successful treatment of hydatid cyst of lesser sac with pair therapy

Hydatid disease has varied presentations and may involve any part of the body with hydatid disease of the liver being the most common site. Hydatid disease of lesser sac is a rare entity. Different treatment options of hydatid liver disease are available which include surgical, medical and radiological management. Surgical management has its limitations in terms of cost, morbidity, mortality, rate of recurrence and patient fitness to undergo surgery. Medical management alone carries a low chance of cure. Radiological management with PAIR therapy [percutaneous aspiration, injection and re-aspiration] of hydatid liver disease has been well described in literature. However, hydatid disease of lesser sac in itself is a rare entity and its treatment with PAIR procedure has not been described before. We describe a case of hydatid disease of lesser sac treated with the PAIR procedure.

Rupture of liver hydatid cysts into the peritoneal cavity a challenge in endemic regions

To evaluate the clinical presentation and early and long-term outcomes of patients treated surgically for intraperitoneal ruptured liver hydatid cysts. The medical records of 21 patients with rupture of hydatid cysts were evaluated retrospectively between January 2000 and April 2009 at Izmir Ataturk Training and Research Hospital, Izmir, Turkey, as were the records of 368 patients with hydatid cysts. Age, gender, symptoms, laboratory findings, diagnostic procedures, surgical treatment modalities, in-hospital stay, morbidity, mortality and recurrence were evaluated. Sixteen of these patients [76.2%] were women. The mean age was 43.8 years. Cysts were single in 16 cases [76.2%]. In 14 cases [66.7%] cysts were localized only in the right lobe. There was also a cyst in the spleen in 4 patients [19%]. Simple falls or direct abdominal minor trauma was responsible in 8 patients [38.1%], and pedestrian mishaps in 4 [19%]. Nine [42.8%] patients experienced spontaneous rupture. External drainage was performed in 12 [57.1%] patients and omentoplasty in 9 patients [42.8%] to manage the cyst cavity. A total of 11 morbidities developed in 9 patients [42.8%]. There was no postoperative mortality. The mean hospital stay was 11.3 +/- 7.4 days, and mean follow-up was 63.1 +/- 31.3 months. The recurrence rate was 23.8%. The morbidity and recurrence rates of surgical interventions for ruptured hydatid cysts are high. This pathology, although rare, should be included in the differential diagnosis of an acute abdomen in endemic areas

Study of the morphological characteristics of Schistosoma mansoni in mice, squirrels, and hamsters.

This study attempted to describe mophological characteristics of S. mansoni worms. In the present study, 6 hamsters, 35 squirrels and 141 mice were infected with pooled cercariae of Schistosoma mansoni by intraperitoneal and percutaneous routes. The worm recovery rate was 18.2% (257/1,412) in hamsters (Mesocricetus auratus); 10.1% (3,310/32,792) in squirrels (Callosciurus erythraeus roberti) and 16.2% (4,328/26,720) in mice (Swiss strain). There were no significant differences between the sizes of 332 adults studied from three kinds of experimental animals. However, the worms collected from the hepatic portal system were usually larger than those from the peritoneal cavity because the latter almost always remained in the immature stage. We found male S. mansoni with tandem (17-22%), non-tandem (80-83%) and unusual/irregular arrangement (3-5%) of testes. The number of S. mansoni testes found were from 3 to 15 in mice, 3 to 11 in hamsters and 4 to 15 in squirrels. Mature worms had a tendency to reduce their size with aging. The number of S. mansoni cecal loops were from 1 to 5 in mice and hamsters and 1 to 4 in squirrels. The location of the first cecal loop was usually in the anterior part of body (1/4 in females and 1/3 in males), but there were some exceptions. The number of eggs in the uterus of each female worm, were 0-3 in mice, 0-1 in squirrels and hamsters. The average number was 0.75. The location of the ovary was usually situated in the anterior part of body of the worm in the three kinds of experimental animals. A few mated male and female worms of S. mansoni being free in the peritoneal cavity were found to develop to sexual maturity, because eggs were observed in their uteri. Their size was usually found to be considerably smaller than the worms seen in the hepatic portal system, and they had no hematin in their intestinal ceca. Encapsulated eggs were found from the peritoneal cavities of a few mice following intraperitoneal and percutaneous methods of infection.

Schistosoma mansoni: inflammatory foci around larvae in the peritoneal cavity of naive mice is radiosensitive

Innate attack to Schistosoma mansoni cercariae was evaluated in irradiated mice. It was observed that 70 percent of the larvae from mice sacrificed one day after whole body irradiation with 400 or 800 rads were surrounded by cluster reactivities, without difference from controls. Differences were apparent on day 5 after irradiation with sub lethal (400 rads) or lethal doses (800 rads) suggesting that innate defence to infection take at least 5 days to be affected by low dose whole-body radiation

Spontaneous intraperitoneal expulsion of an unruptured hydatid cyst

We report a 43-year-old man with a 20 x 20 cm hydatid cyst, spontaneously extruded out from the left lobe of the liver. This complication of hydatid cyst has not been recorded earlier, and makes the case unique in itself and worth reporting. The patient presented with a rare complication of biliary peritonitis of hydatid disease

Schistosoma mansoni: host cell adhesion to the different stages of the parasite, in vivo

The peritoneal cavity of laboratory mice was used to study the phenomenon of host cell adhesion to different evolutive stages of the Schistosoma mansoni (cercaria, adult worm, developing and mature eggs, miracidium, young and mature daughter sporocysts). Material recovered from the peritoneal cavity 30 and 180 min after the inoculation of each evolutive form was examined with the help of a stereomicroscope. The free swimming larvae (cercaria and miracidium), and the evolutive forms producing such larvae (mature egg and mature daughter sporocyst) elicited the host cell adhesion phenomenon. In all forms but cercariae the adherent cells remained as so till 180 minutes after inoculation

Differences between in vitro and in vivo obtained schistosomules

Injecao de cercarias de Schistosoma mansoni na cavidade peritoneal de camundongos normais induz adesao celular a estas lavras. Esta aderencia diminui acentuadamente quando as lavras infectantes se transformam em esquistossomulos. Este procedimento foi usado para detectar diferencas entre esquitossomulos obtidos in vivo e in vitro. A reinoculacao de esquistossomulos obtidos in vivo na cavidade peritoneal de camundongos nao acarreta adesao celular. Por outro lado, celulas aderentes foram encontradas em esquistossomulos obtidos in vitro (4 e 24 horas, respectivamente). Nossos dados referentes a esquistossomulos obtidos in vitro indicam que mais de 24 horas sao necessarias para a completa remocao de moleculas envolvidas no fenomeno de adesao celular