Complicated Liver Cystic Echinococcosis—A Comprehensive Literature Review and a Tale of Two Extreme Cases

IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Tomography Pub Date : 2024-06-11 DOI:10.3390/tomography10060070
V. Calu, O. Enciu, E. Toma, R. Pârvuleţu, Dumitru Cătălin Pîrîianu, Adrian Miron
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Abstract

Cystic echinococcosis is a zoonotic parasitic disease that affects the liver in more than 70% of cases, and there is still an underestimated incidence in endemic areas. With a peculiar clinical presentation that ranges from paucisymptomatic illness to severe and possibly fatal complications, quality imaging and serological studies are required for diagnosis. The mainstay of treatment to date is surgery combined with antiparasitic agents. The surgical armamentarium consists of open and laparoscopic procedures for selected cases with growing confidence in parenchyma-sparing interventions. Endoscopic retrograde cholangiopancreatography (ERCP) is extremely useful for the diagnosis and treatment of biliary fistulas. Recent relevant studies in the literature are reviewed, and two complex cases are presented. The first patient underwent open surgery to treat 11 liver cysts, and during the follow-up, a right pulmonary cyst was diagnosed that was treated by minimally invasive surgery. The second case is represented by the peritoneal rupture of a giant liver cyst in a young woman who underwent laparoscopic surgery. Both patients developed biliary fistulas that were managed by ERCP. Both patients exhibited a non-specific clinical presentation and underwent several surgical procedures combined with antiparasitic agents, highlighting the necessity of customized treatment in order to decrease complications and successfully cure the disease.
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复杂的肝囊性棘球蚴病--全面的文献综述和两个极端病例的故事
囊性棘球蚴病是一种人畜共患的寄生虫病,70%以上的病例会影响肝脏,而且在流行地区的发病率仍被低估。该病临床表现奇特,从无症状的疾病到严重甚至可能致命的并发症,因此需要进行高质量的影像学和血清学检查才能确诊。迄今为止,治疗的主要方法是手术结合抗寄生虫药物。外科手术包括开腹手术和腹腔镜手术,适用于特定病例。内镜逆行胰胆管造影术(ERCP)对胆道瘘的诊断和治疗非常有用。本文回顾了最近的相关文献研究,并介绍了两个复杂病例。第一例患者接受了开腹手术治疗 11 个肝囊肿,在随访期间诊断出右肺囊肿,并通过微创手术进行了治疗。第二个病例是一名年轻女性的巨大肝囊肿腹膜破裂,她接受了腹腔镜手术。这两名患者都出现了胆道瘘,并通过ERCP进行了处理。这两名患者的临床表现均无特异性,并接受了数次手术治疗,同时使用了抗寄生虫药物,这突出表明了为减少并发症并成功治愈疾病而进行个性化治疗的必要性。
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来源期刊
Tomography
Tomography Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
2.70
自引率
10.50%
发文量
222
期刊介绍: TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.
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