Hydatid cysts in muscles: clinical manifestations, diagnosis, and management of this atypical presentation.

INTRODUCTION: Hydatid cysts are rarely detected in muscle tissue (0.7-0.9%), even in endemic countries. The aim of this study was to present information regarding the clinical manifestations, diagnosis, and management of muscle echinococcosis. METHODS: Twenty-two patients with hydatid cysts in the muscle were followed from January 2006 through December 2014. RESULTS: Twenty-four sites of muscle involvement were observed in the 22 patients. Fifteen (68%) of our patients were women, while seven (32%) were men. The mean age was 28.1 ± 15.4 (6-61) years. The most frequent locations were the thigh (27.2%) and the paravertebral region (13.6%). Most patients reported a painless slow-growing mass with normal overlying skin. Most (90.2%) cases were treated by surgical excision and fine-needle aspiration. CONCLUSIONS: Primary muscle hydatid cyst should be considered in the differential diagnosis in cystic masses of the muscular system without pain and localized enlargement of soft tissue, especially in endemic areas. Hydatid cyst should be investigated using serological tests and imaging modalities. If possible, total surgical excision of hydatid cyst in the muscle should be performed.

Hydatid cysts in muscles: clinical manifestations, diagnosis, and management of this atypical presentation

ABSTRACTINTRODUCTION: Hydatid cysts are rarely detected in muscle tissue (0.7-0.9%), even in endemic countries. The aim of this study was to present information regarding the clinical manifestations, diagnosis, and management of muscle echinococcosis.METHODS: Twenty-two patients with hydatid cysts in the muscle were followed from January 2006 through December 2014.RESULTS: Twenty-four sites of muscle involvement were observed in the 22 patients. Fifteen (68%) of our patients were women, while seven (32%) were men. The mean age was 28.1 ± 15.4 (6-61) years. The most frequent locations were the thigh (27.2%) and the paravertebral region (13.6%). Most patients reported a painless slow-growing mass with normal overlying skin. Most (90.2%) cases were treated by surgical excision and fine-needle aspiration.CONCLUSIONS: Primary muscle hydatid cyst should be considered in the differential diagnosis in cystic masses of the muscular system without pain and localized enlargement of soft tissue, especially in endemic areas. Hydatid cyst should be investigated using serological tests and imaging modalities. If possible, total surgical excision of hydatid cyst in the muscle should be performed.

Diameters of the common bile duct in adults and postcholecystectomy patients: a study with 64-slice CT.

This study aims to collect data by multidetector computed tomography (MDCT) on the diameter of the normal common bile duct (CBD) and the diameter of CBD after cholecystectomy. In this retrospective study, CBD measurements were performed on axial oblique images, perpendicular to the long axis of the distal CBD. The mean diameter of the normal CBD was measured in 604 patients without cholecystectomy. The patients were divided into 6 groups according to their age. Analysis of variance (ANOVA) was used to compare data obtained from the six age groups. The mean diameter of the CBD of 46 patients who had cholecystectomy was calculated. The results were compared with age matched control group by Student's t test. The largest diameter of CBD ranged from 1.8 to 11.8mm. The mean of the largest diameter of 604 subjects was 4.77 ± 1.81. The diameter of the CBD significantly increased with age. Mean largest CBD diameters of postcholecystectomy subjects (7.28 ± 2.37) were significantly greater than age matched control group. In conclusion the diameter of CBD shows a considerable increase with age. The largest diameter of the CBD is up to 6mm in most of the subjects. An upper limit of 8mm appears reasonable after the age of 50; and an upper limit of 10mm seems appropriate for cholescystectomized subjects.

Non-invasive evaluation of vertebral artery blood flow in cervical spondylosis with and without vertigo and association with degenerative changes.

Cervical spondylosis is a common disease that results from degenerative changes of the cervical spine and vertigo may occur in this process. The aim of the present study was to assess the blood flow measurements of the vertebral artery (VA) using color Doppler ultrasonography (CDUS) in patients who have cervical spondylosis with and without vertigo. The study population included 101 patients with vertigo and spondylosis, 66 patients with spondylosis without vertigo, and 62 healthy controls. A bilateral decrease in the VA blood flow velocities were measured in patients with cervical spondylosis. A negative correlation was found between the stage of cervical degenerative changes and the flow velocities in patients with vertigo, while this relationship was not found in patients without vertigo. The CDUS evaluation of the pretransverse and transverse segments of VAs demonstrated significantly reduced flow velocities in patients with spondylosis. The degenerative changes in the cervical spine seem to be related to these velocity changes in the subgroup of patients who are also affected with vertigo. The pretransverse segment of the VA provides valuable measurements as well as transverse segment of the VA, and it can be used as an appropriate segment for CDUS examination in cervical spondylosis and associated vertigo.