肝包虫囊破裂致下腔静脉肺动脉栓塞:临床及影像学表现

Parham Rabiee, S. Rezvan, M. Khajeh-Azad, Mohammad-Hossein Mokhtarian, Alireza Sharifi
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摘要

背景与目的:由包虫病引起的肺栓塞是一种非常罕见且致命的并发症,由包虫病心脏破裂或内脏包虫病释放到静脉循环中引起。通过对比增强计算机断层扫描(CT)和磁共振成像(MRI),可以将包虫性肺栓塞与其他类型的肺栓塞区分开来。MRI比CT更能显示病变的囊性。肝包虫病患者如果突然出现胸痛和呼吸困难,特别是在包虫病流行的地区,应注意肺栓塞。本报告旨在介绍该患者的临床和影像学特征,并讨论诊断和治疗方法。病例介绍:在这里,我们报告了一位45岁的男性,由于下腔静脉的包虫肝囊肿破裂而导致肺栓塞。在我们的病人中发现了多个动脉内肺包虫囊肿栓子,起源于肝包虫囊肿破裂进入下腔静脉的肝脏部分。病人拒绝手术治疗。因此,患者使用安达唑(阿苯达唑)和盐酸西替利嗪治疗。结论:本病例很有趣,因为由包虫囊肿引起的肺栓塞是一种非常罕见的临床疾病。有可能在诊断和治疗包虫囊肿困难,和一个明确的诊断是可能的,只有通过组织病理学检查。
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Pulmonary Artery Embolism Due to a Ruptured Hepatic Hydatid Cyst Into the Inferior Vena Cava: Clinical and Radiologic Imaging Findings
Background and Aim: Pulmonary embolism because of hydatid cysts is a very uncommon and lethal complication caused by a hydatid heart cyst rupture or a visceral hydatid cyst released into the venous circulation. By utilizing contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI), hydatid pulmonary embolism can be differentiated from other types of pulmonary embolism. MRI mainly displays the cystic nature of lesions better than CT. Pulmonary embolism should be kept in mind in patients with hepatic hydatidosis if there is a sudden occurrence of chest pain and dyspnea, particularly in regions where hydatidosis is endemic. This report aims to present the clinical and radiographic features and discuss the diagnosis and treatment procedure of our patient. Case Presentation: Here, we report a 45-year-old man with pulmonary embolism as a consequence of a ruptured hydatid liver cyst in the inferior vena cava. Multiple intra-arterial pulmonary hydatid cyst emboli originating from a hepatic hydatid cyst ruptured into the hepatic portion of the inferior vena cava were seen in our patient. The patient refused the surgical treatment. Therefore, the patient was treated using Andazol (Albendazole) and Cetirizine hydrochloride. Conclusion: The present case is interesting because pulmonary embolism caused by hydatid cysts is a very uncommon clinical entity. There may be difficulties in diagnosing and treating hydatid cysts, and a definitive diagnosis was possible only by a histopathological examination.
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