Palacios-Ruíz JA, Ramírez-Solís ME, Moreno-Möller M, Cárdenas-Mejía A, González-Monroy LE, Díaz-Pizarro JI, Mata-Miranda MP, Aguirre MT, Bonilla C, Maravilla P, Flisser A

Language: Spanish
References: 13
Page: 206-210
PDF size: 137.16 Kb.

ABSTRACT

Liver hydatid disease is the most frequent hepatic parasitic disease in developed countries. Hydatid disease has been considered practically absent in Mexico. In this paper we report the identification, management and initial epidemiologic studies of an autochthonous case of hydatid disease from central Mexico. Case report: The patient is a 38 year-old female from Teoloyucan, resident of Tepotzotlan, State of Mexico, with family history of no importance for her actual disease. Her chief complaint was pain in the right hypocondrium, that began two months before her admission to the hospital, cramps located in the same abdominal area. The ultrasound and computed tomography scan showed a solitary cyst measuring about 6 cm and containing undulated hyperechogenic membranes which floated within the cyst fluid, the Casoni’s intradermal reaction was positive. Laparoscopic surgery was performed, the cyst was punctured in order to aspirate the cyst fluid and instill 100 cc of a hypertonic saline solution (17%) as a scolicidal agent (this technique is called PAIR, percutaneous-aspiration-injection-reaspiration), laparoscopic pericystectomy was performed, the patient was discharged 7 days after without complications. Conclusion: The surgical management of this case indicated that laparoscopy is reliable technique and easy to perform. In spite of lack of expertise for treating liver hydatid cyst by laparoscopy, was decided to use this surgical technique because the lesion was in the right hepatic lobule and was free, no fixed to other intra-abdominal organs. Furthermore, the laparoscopic procedure included all recommended approaches for the treatment of hydatid disease, that is PAIR and excision of the germinal layer. The protoscolices were killed with the trans-surgical treatment with hypertonic saline solution.

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