Coinfection with hepatic cystic and alveolar echinococcosis with abdominal wall abscess and sinus tract formation: A case report.

BACKGROUND: Hepatic cystic and alveolar echinococcosis coinfections, particularly with concurrent abscesses and sinus tract formation, are extremely rare. This article presents a case of a patient diagnosed with this unique presentation, discussing the typical imaging manifestations of both echinococcosis types and detailing the diagnosis and surgical treatment experience thereof. CASE SUMMARY: A 39-year-old Tibetan woman presented with concurrent hepatic cystic and alveolar echinococcosis, accompanied by abdominal wall abscesses and sinus tract formation. Initial conventional imaging examinations suggested only hepatic cystic echinococcosis, but intraoperative and postoperative pathological examination revealed the coinfection. Following radical resection of the lesions, the patient's condition improved, and she was discharged soon thereafter. Subsequent outpatient follow-ups confirmed no recurrence of the hydatid lesion and normal surgical wound healing. Though mixed hepatic cystic and alveolar echinococcosis with abdominal wall abscesses and sinus tract formations are rare, the general treatment approach remains consistent with that of simpler infections of alveolar echinococcosis. CONCLUSION: Lesions involving the abdominal wall and sinus tract formation, may require radical resection. Long-term prognosis includes albendazole and follow-up examinations.

Historical changes in surgical strategy and complication management for hepatic cystic echinococcosis.

Echinococcosis is a zoonotic parasitic disease caused by Escherichia larvae. It frequently involves the liver (70%-75%), followed by the lungs (15%-20%), and occasionally the brain, heart, spleen, bone, and other organs. The main pathogenic forms of human echinococcosis currently include cystic echinococcosis (CE) and alveolar echinococcosis (AE). CE is globally distributed, while the distribution of AE is generally restricted to the northern hemisphere. In China, CE accounts for 75% of all echinococcosis cases. With rapid advances in surgical techniques in recent decades, the surgical strategy for CE has changed, especially with the continuous improvement of surgical methods and the expansion of surgical contraindications. To further understand the changes in surgical treatment strategies for hepatic CE, we interpreted and analyzed the existing literature addressing the surgical treatment of hepatic CE both domestically and abroad and briefly summarized them in chronological order. This review aims to provide a deeper understanding of the progress in the surgical treatment of hepatic CE to provide clearer avenues for its clinical diagnosis and treatment.

Diagnosis and treatment of mixed infection of hepatic cystic and alveolar echinococcosis: Four case reports.

BACKGROUND: Mixed infection of hepatic cystic and alveolar echinococcosis is extremely rare. This article reveals the typical imaging manifestations of cystic and alveolar echinococcosis and investigates the diagnosis and surgical experience of mixed infection of hepatic cystic and alveolar echinococcosis. CASE SUMMARY: From January 2017 to May 2019, 4 cases with rare mixed infection of hepatic cystic and alveolar echinococcosis were admitted and treated by the Division of General Surgery of Qinghai Provincial People's Hospital. Three of the patients occasionally had upper abdominal discomfort, but it did not affect their daily lives. However, hepatic echinococcosis was found in one patient by physical examination, and the patient had no discomfort. All 4 cases were Tibetans who had lived in pastoral areas of southern Qinghai for a long time. Enzyme-linked immunosorbent assay for echinococcosis was positive for all patients. Moreover, abdominal computed tomography showed typical imaging manifestations of cystic and alveolar echinococcosis including coexisting "honeycomb sign," and "spotted calcification." Three of the patients underwent radical resection, and 1 case underwent palliative resection. All 4 patients developed different types of surgical complications after the operation, but all of them recovered and were discharged after symptomatic treatment. CONCLUSION: There are no problems diagnosing mixed infection of hepatic cystic and alveolar echinococcosis. The difficulties involve preoperative evaluation and treatment of surgical complications.