LeGoo polymer injection into hydatid cyst would eliminate intraoperative spillage of scolices.

BACKGROUND: Hydatid disease is caused by the tapeworm Echinococcus granulosus or Echinococcus multilocularis or Echinococcus Vogeli. It is the most severe helminthic zoonosis, with a major medical, social, and economic burden in endemic areas such as the Mediterranean region, South America, Australia, Turkey, New Zealand, Alaska, Canada, and the Middle East. The cornerstone in the management of hydatid cysts is surgery, and its recurrence is due mainly to the spillage of hydatid scolices rich fluid into the surrounding tissues. AIM: In this study, we test a polymer benefit in intraoperative scolices spillage prevention, this polymer is called LeGoo. METHODS: The LeGoo polymer was used here in vivo animal's hydatid cysts and in vitro hydatid cysts excised from human beings. RESULT: Microscopic examination of the aspirated fluid from human being and sheep hydatid cysts before LeGoo injection showed numerous alive scolices. All sheep lung hydatid cysts with LeGoo injection transformed into a solid gelatinous mass, microscopic examination of the content swabs showed no scolices. LeGoo polymer injection into human hydatid cysts in vitro changed them into a solid gelatinous mass that can be mobilized easily with negative swabs for scolices.

Liver hydatid cyst with transdiaphragmatic rupture and lung hydatid cyst ruptured into bronchi and pleural space.

The aim of this case study is to present effectiveness of percutaneous drainage as a treatment option of ruptured lung and liver hydatid cysts. A 65-year-old male patient was admitted with complicated liver and lung hydatid cysts. A liver hydatid cyst had ruptured transdiaphragmatically, and a lung hydatid cyst had ruptured both into bronchi and pleural space. The patient could not undergo surgery because of decreased respiratory function. Both cysts were drained percutaneously using oral albendazole. Povidone-iodine was used to treat the liver cyst after closure of the diaphragmatic rupture. The drainage was considered successful, and the patient had no recurrence of signs and symptoms. Clinical, laboratory, and radiologic recovery was observed during 2.5 months of catheterization. The patient was asymptomatic after catheter drainage. No recurrence was detected during 86 months of follow-up. For inoperable patients with ruptured liver and lung hydatid cysts, percutaneous drainage with oral albendazole is an alternative treatment option to surgery. The percutaneous approach can be life-saving in such cases.

[The solitary echinococcal cyst--a rare cause of a round pulmonary focus]. / Solitäre Echinokokkuszyste--seltene Ursache eines pulmonalen Rundherdes.

HISTORY AND ADMISSION FINDINGS: A 29-year-old man from Kazakhstan presented with right-sided chest pain, cough, whitish sputum and a temperature up to 38.5 degrees C. He had been working in an animal farm for the previous two years. INVESTIGATIONS: Laboratory tests showed increased inflammatory parameters (WBC 15.9 gpt/l with an increased proportion of band and segmented granulocytes, C-reactive protein (242.3 mg/dl). Chest radiogram showed an infiltration and effusion in the right base judged to be due to pneumonia. In addition there was a round homogeneous mass, 2.5 cm in diameter, at the lateral thoracic wall in the 8th lower lobe segment. Computed tomography (CT) of the lung and mediastinum confirmed these findings. Bronchoscopy, echocardiography, upper abdominal sonography and CT of the skull revealed no other space-occupying lesion. DIAGNOSIS, TREATMENT AND COURSE: The right-sided pneumonia was successfully treated, at first with ceftriaxone (i.v.), later with ofloxacin (by mouth). An echinococcal cyst was considered especially because of the patient's profession in Kazakhstan in the differential diagnosis of the right-sided round mass and confirmed by an indirect haemagglutination test giving an antibody titre of 1:1024. In response a thoracotomy was performed and the mass, histologically an echinococcal cyst (E. granulosa), resected. There were no other cysts. There was no explanation for the right-sided pneumonia. CONCLUSIONS: Even though Echinococcosis is rare in Central Europe, it should be included in the differential diagnosis of a round pulmonary mass. A detailed history, especially with regard to occupation and country of origin, is essential. Serological tests for specific Echinococcus antibodies, together with usual imaging procedures, will usually and quickly provide the diagnosis.