RESUMO
We present a woman 34 years old with echinococcosis of intra and extra hepatic biliary ducts including gallbladder. We found alive cysts, dead cysts and fragments of germinative membranes of a complicated cyst in left lobe (I - II) with clinical findings of obstructive jaundice; pain; cholecystitis and great dilation of biliary ducts. We performed left lobectomy, exploration of biliary ducts, transduodenal sphincteroplasty, cholecystectomy. We haven't had complications. We present ultrasound images of the pathologic pieces.
Assuntos
Doenças dos Ductos Biliares/patologia , Equinococose/patologia , Doenças da Vesícula Biliar/patologia , Adulto , Doenças dos Ductos Biliares/diagnóstico por imagem , Doenças dos Ductos Biliares/parasitologia , Doenças dos Ductos Biliares/cirurgia , Colecistectomia , Colecistite/etiologia , Colestase/etiologia , Doenças do Ducto Colédoco/diagnóstico por imagem , Doenças do Ducto Colédoco/parasitologia , Doenças do Ducto Colédoco/patologia , Doenças do Ducto Colédoco/cirurgia , Dilatação Patológica , Equinococose/diagnóstico por imagem , Equinococose/cirurgia , Equinococose Hepática/diagnóstico por imagem , Equinococose Hepática/cirurgia , Feminino , Doenças da Vesícula Biliar/diagnóstico por imagem , Doenças da Vesícula Biliar/parasitologia , Doenças da Vesícula Biliar/cirurgia , Hepatectomia , Humanos , Esfincterotomia Transduodenal , UltrassonografiaRESUMO
We present a retrospective and descriptive study of 21 surgeries of echinocociosis of the liver, corresponding to 30% of a universe of 70 patients that were studied at HMC from 1990 to 1999; other places were 67% in the lung, 1.5% in peritoneal cavity and 1.5% in the spleen.We analyzed frequency in relation to sex, age, origin of the patient, clinical findings, serological tests, radiological tests, abdominal ecography, CT, surgical procedure, morbility and mortality and stay at hospital.These are the results:The average age was 29 years; 76.19% male and 23.81 %female; pain of the right superior quadrant was 66%, palpable mass with 38%.57.14% were from endemic region. We did serological test in 52.4% of the patients; V arc 42.8%; ELISA 23.8%; W. Blot in 33% with 100% of positive results. Eosinophilia was found in 80.95%; echographic studies were realized in 100%; CT in 61.9%; hepatic gammagraphy in 14.2%. Surgical treatment was conservative in 95.2% and radical in 4.3%.42.8% were complicated cysts. Postoperative complications were present in 66%; the most frequent was fever. The rate of mortality was 0%. The average of stay at hospital was 74 days.
