腹膜内包虫囊破裂的手术结果和处理策略:回顾性分析。

Bilal Turan, Nurullah Bilen, Emre Teke, Serdar Acar, İsa Karaca, Sibel Yaman
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摘要

背景:包虫病是一种由棘球绦虫引起的寄生虫感染,主要影响肝脏和肺部,有可能自发或外伤性破裂进入腹腔。虽然包虫囊肿穿孔是罕见的,但需要紧急手术干预,以防止严重的并发症,如过敏反应,胆漏,继发感染。方法:回顾性分析2017年至2022年在某普外科诊所治疗的13例包虫囊肿穿孔患者。我们回顾了有关临床表现、诊断方法、手术入路、术后结果和随访的资料。所有的患者都接受了紧急手术,包括囊肿清除、腹腔灌洗和术后阿苯达唑治疗。结果:该队列包括8名男性和5名女性患者,平均年龄33岁。自发性穿孔12例,外伤1例。肝脏是最常见的受累器官(92.3%)。手术干预包括部分膀胱切除术和网膜切除术12例。复发率为8%。术后并发症极少,包括两例自发解决的胆管瘘和一例伤口感染。平均住院时间9.2天,平均随访时间18.8个月。1例肝硬化患者死于门静脉高压并发症。结论:包虫囊肿破裂是一种罕见但可能危及生命的疾病,特别是在流行地区。及时的手术干预,结合术后阿苯达唑治疗,是必要的,以减少发病率,死亡率和复发率。建议终生监测腹膜内穿孔的患者,以管理包虫病的潜在并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Surgical outcomes and management strategies in intraperitoneal rupture of hydatid cysts: A retrospective analysis.

Background: Hydatid cyst disease, a parasitic infection caused by Echinococcus species, primarily affects the liver and lungs, with potential for spontaneous or traumatic rupture into the peritoneal cavity. Although hydatid cyst perforation is rare, it necessitates urgent surgical intervention to prevent severe complications such as anaphylaxis, bile leakage, and secondary infection.

Methods: This retrospective study analyzed 13 patients with hydatid cyst perforation who were treated in a general surgery clinic between 2017 and 2022. Data regarding clinical presentation, diagnostic methods, surgical approaches, postoperative outcomes, and follow-up were reviewed. All patients underwent emergency surgery involving cyst evacuation, peritoneal lavage with scolicidal agents, and postoperative albendazole therapy.

Results: The cohort included eight male and five female patients, with a mean age of 33 years. Spontaneous perforation occurred in 12 cases, and one case was due to trauma. The liver was the most commonly affected organ (92.3%). Surgical interventions consisted of partial cystectomy with omentopexy in 12 patients. The recurrence rate was 8%. Postoperative complications were minimal, including two bile fistulas that resolved spontaneously and one case of wound infection. The average hospital stay was 9.2 days, and the mean follow-up duration was 18.8 months. One patient with cirrhosis died due to complications from portal hypertension.

Conclusion: Hydatid cyst rupture is a rare but potentially life-threatening condition, particularly in endemic regions. Prompt surgical intervention, combined with postoperative albendazole therapy, is essential to reduce morbidity, mortality, and recurrence. Lifelong monitoring is recommended for patients with intraperitoneal perforations to manage potential complications of hydatidosis.

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