scholarly journals Open Surgery for Hepatic Hydatid Disease

2014 ◽  
Vol 99 (6) ◽  
pp. 764-769 ◽  
Author(s):  
Erdogan Sozuer ◽  
Muhammet Akyuz ◽  
Sami Akbulut

Abstract Hydatid disease is a zoonosis caused by the larvae of Echinococcus granulosus. Humans are an intermediate host and are usually infected by direct contact with dogs or indirectly by contaminated foods. Hydatid disease mainly involves the liver and lungs. The disease can be asymptomatic. Imaging techniques such as ultrasonography and computed tomography are used for diagnosis. The growth of hydatid cysts can lead to complications. Communication between bile duct and cysts is a common complication. The goal of treatment for hydatid disease is to eliminate the parasite with minimum morbidity and mortality. There are 3 treatment options: surgery, chemotherapy, and interventional procedures. Medical treatment has low cure and high recurrence rates. Percutaneous treatment can be performed in select cases. There are many surgical approaches for managing hydatid cysts, although there is no best surgical technique, and conservative and radical procedures are used. Conservative procedures are usually preferred in endemic areas and are easy to perform but are associated with high morbidity and recurrence rates. In these procedures, the parasite is sterilized using a scolicidal agent, and the cyst is evacuated. Radical procedures include hepatic resections and pericystectomy, which have high intraoperative risk and low recurrence rates. Radical procedures should be performed in hepatobiliary centers. The most common postoperative complications are biliary fistulas and cavity-related complications. Endoscopic retrograde cholangiopancreatography can be used to diagnose and treat biliary system complications. Endoscopic sphincterotomy, biliary stenting, and nasobiliary tube drainage are effective for treating postoperative biliary fistulas.

Author(s):  
Mohammad MOAZENI ◽  
Mohammad Jamal SAHARKHIZ ◽  
Amir Mootabi ALAVI

Background: New scolicidal agents and novel therapeutic drugs are essential for better management of the zoonotic infection, hydatid disease. This study evaluated the effect of a nanoemulsion (NE) of Satureja hortensis essential oil (SHEO) on protoscoleces and germinal layer of hydatid cysts. Methods: This study was conducted from July to October 2016 in Shiraz University, Shiraz, Iran. Gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) were performed to identify the main components of SHEO. To determine the scolicidal power of the NE of SHEO, live protoscoleces of hydatid cysts were exposed to two concentrations (1 and, 2 mg/mL) of the NE and incubated at 37 °C for 10 and 20 min. To evaluate the anti-hydatid effect of the NE of SHEO, the collected hydatid cysts from the abdominal cavities of the experimentally infected mice were immersed in the NE (0.5 mg/ml) and incubated at 22 °C for 24 h. Results: Carvacrol and γ-terpinene were the major components of the SHEO. NE of SHEO at the concentrations of 1 and 2 mg/mL showed 100% scolicidal power after 20 and 10 min respectively. Exposure of the hydatid cysts to the NE of SHEO resulted in crumpling of their germinal layer and detachment of this layer from the laminated layer. Conclusion: NE of SHEO showed a strong scolicidal activity as well as a profound lethal effect on the germinal layer of hydatid cysts. Accordingly, this product may be used as a natural scolicidal agent in hydatid cyst surgery. Furthermore, it may be used as a therapeutic tool for treatment of hydatid disease.


2019 ◽  
Vol 104 (5-6) ◽  
pp. 232-238
Author(s):  
Adalet Elcin Yildiz ◽  
Baris Dogu Yildiz ◽  
Mesut Tez

This article aims to compare available treatment options for type III liver hydatid cysts, including surgery and percutaneous techniques. Hydatid disease is a helminthic infection caused by Echinococcus granulosus and is a serious public health problem in endemic regions of the world. Hydatid cyst of the liver is the most common clinical presentation of Echinococcus granulosus. According to Gharbi classification, hydatid cysts of the liver are classified into 5 types. Type III hydatid cysts are those with fluid collection and septa. Treatment of Gharbi type III hydatid cysts is still controversial. Some researchers think that Gharbi type III hydatid cysts are not suitable for percutaneous drainage, and surgery is the suitable treatment option. There are not enough prospective studies comparing percutaneous and surgical techniques for the treatment of type III hydatid disease of the liver. A proper meta-analysis does not seem to be possible with the available studies in current medical literature.


2015 ◽  
Vol 53 (200) ◽  
pp. 270-274
Author(s):  
Altaf Ahmed Talpur ◽  
Aijaz Ahmed Shaikh ◽  
Muhammad Imran Arain ◽  
Akmal Jamal Siddiqui

Introduction: Hydatid disease is a significant health problem with their location at Extrahepatic Intra abdominal sites is a very rare disease. Disease in these sites usually found concurrently with liver hydatid disease. Diagnosis is based blood tests & imaging studies. Surgery is the mainstay of treatment. This study will help us in determining the frequency of Extra Hepatic Intra Abdominal Hydatid Disease. Also different methods to diagnose & treat the disease will be evaluated.   Methods: It includes patients of extra hepatic intra abdominal Hydatid cyst above 13 years and underwent surgery from 2009 to 2014. Variables include age, sex, clinical findings, diagnostic investigations, operative findings, operative procedure, post operative complications. Results: Eleven patients; 07 male & 04 female; mean age 37.54 years. Most common symptoms were mass in abdomen in 11 patients & dull pain abdomen in 09 (81.8%) patients. Examination revealed non tender mass in epigastric & umbilical region in 04 (36.3%) patients. Ultrasound Abdomen showed hydatid cyst spleen in 02 (18.1%) patients, epigastrium in 04 (36.3%) patients, beneath left crus of diaphragm in 02 (18.1%) patients & right iliac fossa & pelvis in 1 (9.09%) patient. In 02 (18.1%) patients multiple Hydatid cysts were noted. Hydatid cysts liver found in 07 (63.6%) patients. C.T scan Abdomen was performed in 09 (81.8%) patients. Surgical procedures performed include Saucerization & omental packing in liver Hydatid cysts; Splenectomy for Splenic disease & complete excision of remaining intra-abdominal Hydatid cysts. Postoperative complications noted in 05  (45.4%) patients. Conclusions: Extra hepatic intra abdominal is an infrequent disease presents significant diagnostic & therapeutic challenge for surgeons. Keywords: extra hepatic; hydatid disease;  intra abdominal.


2011 ◽  
Vol 7 (1) ◽  
pp. 51 ◽  
Author(s):  
Frederic Baumann ◽  
Nicolas Diehm ◽  
◽  

Patients with critical limb ischaemia (CLI) constitute a subgroup of patients with particularly severe peripheral arterial occlusive disease (PAD). Treatment modalities for these patients that often exhibit multilevel lesions and severe vascular calcifications are complicated due to multiple comorbidities, i.e. of cardiac and vascular but also of renal origin. These need to be taken into consideration while planning treatment options. Although CLI is associated with considerably high morbidity and mortality rates, the clinical outcome of patients being subjected to revascularisation has improved substantially in recent years. This is mainly due to improved secondary prevention strategies as well as dedicated endovascular innovations for this most challenging patient cohort. The aim of this article is to provide a discussion of the contemporary treatment concepts for CLI patients with a focus on arterial revascularisation.


2006 ◽  
Vol 186 (4) ◽  
pp. 1198-1199 ◽  
Author(s):  
Enrico Brunetti ◽  
Carlo Filice ◽  
Valeria Meroni

2020 ◽  
Vol 5 (1) ◽  
pp. 58-64
Author(s):  
Giuseppe Toro ◽  
Antimo Moretti ◽  
Marco Paoletta ◽  
Annalisa De Cicco ◽  
Adriano Braile ◽  
...  

Hip fractures are severe conditions with a high morbidity and mortality, especially when the diagnosis is delayed, and if formulated over 30 days after the injury, is termed a ‘neglected femoral neck fracture’ (NFNF). Cerebral palsy (CP) is probably one of the major risk factors for NFNF in Western countries, mainly because of both cognitive and motor impairments. However, considering the high prevalence of fractures in these patients, the incidence of NFNF in this population is probably underestimated, and this condition might result in persistent hip or abdominal pain. Several techniques are available for the treatment of NFNF (i.e. muscle pedicle bone graft, fixation with fibular graft, valgisation osteotomy), but most of them could affect motor function. Motor function must be preserved for as long as possible, in order to enhance the quality of life of CP patients. After discussing published NFNF cases in CP patients and available treatment options, a practical approach is proposed to facilitate the orthopaedic surgeon to both early identify and appropriately manage these challenging fractures. Cite this article: EFORT Open Rev 2020;5:58-64. DOI: 10.1302/2058-5241.5.190019


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