Disasters that develop in the liver due to hydatid cyst: a case report.

Hilar cavernous transformation is the formation of venous structures rich in collateral around the portal vein. Portal vein thrombosis is a rare entity. Although there are many reasons for its etiology, few cases have been reported secondary to hydatid cysts in the liver. Here, we present a 24-year-old patient with complaints of abdominal pain and swelling. Her CT and MRI scans show cholelithiasis with portal vein thrombosis and hilar cavernous transformation due to giant hydatid cyst compression in the lateral liver sector.

La transformación cavernosa hiliar es la formación de estructuras venosas ricas en colaterales alrededor de la vena porta. La trombosis de la vena porta es una afección poco frecuente. Aunque existen muchas razones en su etiología, se han descrito pocos casos secundarios a quiste hidatídico en el hígado. Aquí se presenta el caso de una paciente de 24 años con quejas de dolor abdominal e hinchazón. La tomografía computarizada y la resonancia magnética mostraron colelitiasis con trombosis de la vena porta y transformación cavernosa hiliar por compresión del quiste hidatídico gigante en el sector lateral del hígado.

THERAPEUTIC APPROACH OF COMPLICATED HYDATID DISEASE: ROLE OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN CHOLANGIOHYDATIDOSIS.

BACKGROUND: Hydatid disease, a parasitic infestation caused by Echinococcus granulosus larvae, is an infectious disease endemic in different areas, such as India, Australia, and South America. The liver is well known as the organ most commonly affected by hydatid disease and may present a wide variety of complications such as hepatothoracic hydatid transit, cyst superinfection, intra-abdominal dissemination, and communication of the biliary cyst with extravasation of parasitic material into the bile duct, also called cholangiohydatidosis. Humans are considered an intermediate host, exposed to these larvae by hand-to-mouth contamination of the feces of infected dogs. AIM: This study aimed to highlight the role of endoscopic retrograde cholangiopancreatography in patients with acute cholangitis secondary to cholangiohydatidosis. METHODS: Considering the imaging findings in a 36-year-old female patient with computed tomography and magnetic resonance imaging showing a complex cystic lesion in liver segment VI, with multiple internal vesicles and a wall defect cyst that communicates with the intrahepatic biliary tree, endoscopic biliary drainage was performed by endoscopic retrograde cholangiopancreatography with papillotomy, leading to the discharge of multiple obstructive cysts and hydatid sand from the main bile duct. RESULTS: Clinical and laboratory findings improved after drainage, with hospital discharge under oral antiparasitic treatment before complete surgical resection of the hepatic hydatid cyst. CONCLUSIONS: Endoscopic retrograde cholangiopancreatography is a safe and useful method for the treatment of biliary complications of hepatic hydatid disease and should be considered the first-line procedure for biliary drainage in cases of cholangiohydatid disease involving secondary acute cholangitis.

Hydatid liver disease with portal vein invasion, cavernous transformation and portal biliopathy.

Hydatid disease is a zoonotic parasitic disease, most commonly affecting the liver, lungs and nervous system. Portal vein involvement by hydatid cyst disease is very rare with only few cases published to our knowledge. We describe a case involving a 53-year-old woman with portal vein invasion, cavernous transformation and portal biliopathy.

Recurring hydatide cyst in abdominal cavity. A case report.

Hydatid cyst (hydatidosis or echinococcosis) is an endemic zoonosis caused by ingestion of Echinococcus eggs. This disease is localized to the liver, but can be found elsewhere. It may be asymptomatic or present with compression discomfort or anaphylactic shock due to cyst rupture. The disease can recur. The diagnosis is made by the symptoms and imaging findings. Serological tests are sometimes done. The diagnosis is confirmed with direct observation of the parasite. Treatment is a combination of anthelmintic with minimally invasive or surgical drainage. This report is from a patient with recurrent hydatid cysts in the abdomen.

El quiste hidatídico (hidatidosis o equinococosis) es una zoonosis endémica causada por la ingesta de huevos de Echinococcus. Esta enfermedad se localiza en el hígado, pero también puede encontrarse en otros sitios. Puede ser asintomática o presentarse con molestias por compresión o choque anafiláctico por rotura del quiste. Puede tener recurrencias. El diagnóstico se realiza por los síntomas y los hallazgos en imagenología. En ocasiones se realizan pruebas serológicas. El diagnóstico se confirma con la observación directa del parásito. El tratamiento es una combinación de antihelmíntico con drenaje mínimamente invasivo o quirúrgico. Se reporta el caso de una paciente con quistes hidatídicos recurrentes en el abdomen.

Fístula biliobronquial secundaria a quiste hidatídico hepático en tránsito torácico: caso clínico / Bronchobiliary fistula secondary to hepatic hydatid cyst in thoracic transit: clinical case

Resumen Introducción: En un quiste hidatídico hepático pueden ocurrir una serie de complicaciones de diversa gravedad. Una es el tránsito hepatotorácico (THT), que es el compromiso simultáneo de hígado, diafragma y pulmón secundario a migración de un quiste hidatídico hepático. Objetivo: Presentar una complicación de baja incidencia de un quiste hidatídico hepático como lo es el THT con fistula biliobronquial y posterior resolución quirúrgica. Materiales y Método: Registro clínico, imagenológico y fotográfico del episodio clínico. Resultados: Paciente con diagnóstico de quiste hidatídico en tránsito hepatotorácico con fístula biliobronquial fue sometida a toracotomía, resección en cuña del pulmón incluyendo bronquios comunicantes con el quiste. Paciente presenta evolución clínica e imagenológica favorable. Discusión: Se discuten formas de presentación, complicaciones de la evolución, grados de progresión y ubicaciones anatómicas frecuentes. Se hace énfasis en rol de la clínica e imagenología para diagnóstico y lo controversial del manejo. Conclusión: Tratamiento quirúrgico dependerá de localización de la lesión, estado del quiste, tamaño y experiencia del equipo quirúrgico, siendo una quistectomía con tratamiento de los trayectos fistulosos una buena alternativa.

Introduction: A variety of severe complications can occur in a hepatic hydatid cyst. One of them is the transit from liver to thorax through the diaphragm (HTT). Aim: To present a low impact complication of a hepatic hydatid cyst such as HTT with bronchobiliary fistula and subsequent surgical procedure. Materials and Method: Clinical, imaging, and photographic record of the clinical event. Results: A patient with a diagnosis of hydatid cyst in hepatothoracic transit with bronchobiliary fistula underwent thoracotomy with a wedge resection of the lung, including a cyst-bronchial communication. The patient presents good clinical and imaging evolution. Discussion: Forms of presentation, evolutionary complications, stages of progression, and frequent anatomical locations are discussed. Emphasis is made on the role of the clinical examination and imaging tests for diagnosis and controversial management. Conclusión: Surgical treatment will depend on location of the lesion, experience of the surgical team, condition and size of the cyst, being a cystectomy with the treatment of the fistulous tracts a good alternative.

Radical surgery for liver hydatidosis.

We have carefully read the article by Ramia et al. titled "Radical surgery in hepatic hydatidosis: an analysis of results in an endemic area", where the authors prioritize ultrasonographic assessment according to the World Health Organization (WHO) classification as a strategy for the surgical planning of hepatic hydatid cyst (HHC). However, they did not consider drug therapy or the use of contrast-enhanced computed tomography (CECT) during preoperative assessment, despite them being considered surgical success factors in the literature.

Complete extraction of a long hepatic hydatid cyst with endoscopic retrograde cholangiography.

Hydatid disease or echinococcosis is a systemic zoonosis caused by Echinococcus granulosus larvae. We report the case of a 63 year-old Peruvian female patient who presented with diffuse abdominal pain and jaundice. An abdominal computed tomography (CT) scan was performed that showed a large hepatic hydatid cyst (6 x 6 cm) in segment IV with an apparent communication with the biliary duct. Laboratory results showed hemoglobin 13.2 g/dl, white blood cell (WBC) count 10,600 cell/mm3, normal serum amylase and lipase, total bilirubin 7,5 mg/dl, direct bilirubin 6,2 mg/dl and alkaline phosphatase 234 UI/l. Magnetic resonance cholangiopancreatography (MRCP) showed the same findings of the CT scan plus dilation of the biliary duct.

Ecografía para la evaluación inicial de pacientes con sospecha de hidatidosis hepática / Ultrasound for the initial evaluation of patients with suspected hepatic hydatidosis

La hidatidosis o equinococosis quística es una infección endémica en varias regiones de Argentina. Su forma más frecuente, la hidatidosis hepática, suele ser asintomática por largos periodos de tiempo y, de presentar síntomas, los mismos suelen ser solapados, inespecíficos y crónicos. Por este motivo, los métodos complementarios de diagnóstico resultan indispensables en la valoración de estos pacientes. Entre ellos, la ecografía continúa siendo el método de elección con el que iniciar la evaluación ante la sospecha de hidatidosis hepática; otros métodos, como la serología, la tomografía computada o la resonancia magnética, pueden resultar de utilidad en casos específicos y siempre contextualizados por la clínica, epidemiología, y los hallazgos ecográficos. (AU)

Hydatidosis or cystic echinococcosis is an endemic infection in several regions of Argentina. Its most frequent form, hepatic hydatidosis, is usually asymptomatic for long periods of time and, if symptoms occur, they are usually overlapping, non-specific and chronic. For this reason, complementary diagnostic methods are essential in the evaluation of these patients. Among them, ultrasound remains the method of choice to initiate the evaluation of suspected hepatic hydatidosis; other methods, such as serology, computed tomography or magnetic resonance imaging, may be useful in specific cases and always contextualised by the clinical, epidemiology and ultrasound findings. (AU)