1/15. Surgical management of a hydatid cyst of the hepatic dome ruptured into the biliary tree.Hydatid disease of the liver remains an important and challenging medical problem. Although surgery is considered the treatment of choice for hydatid disease of the liver, controversies still exist about the preferred operative technique. We report the case of a patient with obstructive jaundice caused by rupture of a hydatid cyst of the hepatic dome into the biliary tract. He was managed by a new surgical approach of myoplasty of the right hemidiaphragm combined with preoperative decompression of the bile duct by an endoscopic sphincterotomy. The postoperative course of the patient was uneventful, and he remains well 3 years later. This procedure is simple, requires less time, and has the advantage of avoiding a thoracoabdominal incision, which makes any abdominal reoperation easier.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/15. Sonographic and computed tomographic demonstration of hydatid cysts communicating with the biliary tree.Hepatic hydatid disease is usually silent and discovered incidentally. rupture of a hydatid cyst into the biliary tree is a serious complication and produces a clinical picture of biliary obstruction. We present the cases of 2 patients who had only nonspecific symptoms and laboratory test results indicative of biliary tract obstruction. The results of sonographic examinations of both patients strongly suggested the presence of hepatic hydatid cysts communicating with the biliary tree. CT examination provided additional information in 1 patient but only confirmed the sonographic findings in the other. Both cases were surgically confirmed. Demonstration of the cyst and intrabiliary hydatid contents should form the basis for the diagnosis of a hydatid cyst's rupture into the biliary tree; detecting the point of communication further supports the diagnosis. An accurate preoperative diagnosis of this disease is essential for its prompt surgical management.- - - - - - - - - - ranking = 1.75keywords = tree (Clic here for more details about this article) |
3/15. Alveolar hydatid disease causing total occlusion of the inferior vena cava.Alveolar hydatid disease is a malignancy-like parasitic disease. It is invasive, metastatic, and almost always lethal if left untreated. A case of alveolar hyatid disease presenting with total of the inferior vena cava is reported. This 28-year-old man was referred for elevation of obstructive jaundice. He was a lama and had recently arrived in taiwan after touring temples in nepal, india, and singapore. Computed tomography showed calcified mass which occupied the right hepatic lobe with extension to the left hepatic lobe. The inferior vena cava was occluded and stricture of biliary tree and portal vein at the hilum was also noted. The patient was treated successfully with palliative resection combined with postoperative albendazole. With increasing travel and immigration, clinicians will be more likely to encounter this rare disease, and thus should be able to recognize its symptoms.- - - - - - - - - - ranking = 0.25keywords = tree (Clic here for more details about this article) |
4/15. Ruptured hydatid cyst of the liver with biliary obstruction: presentation of a case and review of the literature.The case of a 66 year old woman admitted with a picture of jaundice acute cholangitis is reported. ultrasonography showed a dilatation of intrahepatic bile ducts, gallbladder hydrops with several stones, enlarged common bile duct (CBD) with hyperechoic material inside and a cystic tumor with hydatid features. With a strong suspicion of a hydatid cyst ruptured in the biliary tree with biliary obstruction, endoscopic cholangiopancreatography was performed. The diagnosis was confirmed by endoscopic retrograde cholangiopancreatography and the hydatid membranes were extracted from the CBD with subsequent clinical improvement. The second step of treatment comprised the surgical cure of the cyst and cholecystectomy. The data from the literature are finally presented with a special emphasis on the ultrasound diagnosis and the endoscopic treatment.- - - - - - - - - - ranking = 0.25keywords = tree (Clic here for more details about this article) |
5/15. common bile duct obstruction caused by the hydatid daughter cysts.echinococcosis is a human parasitary disease. In 2002, 29 new cases of liver echinococcosis were recorded in croatia. liver is the most common site of hydatid cysts. Nine patients with echinoccocal liver disease were operated in our department in 2002. Here we present a case where a patient with verified hydatid cyst in the left liver lobe developed high fever, jaundice, nausea, vomiting and pain in the upper abdomen. The symptoms were initially ascribed to the acute cholangitis. After unsuccessful antibiotic treatment, computerized tomography and endoscopic retrograde cholangiopancreatography (ERCP) were performed, demonstrating daughter cysts in the common bile duct. During ERCP, papilotomy was made and daughter cysts were extracted. Hydatid cyst was surgically removed, and a communication between the cyst and left hepatic duct was noted during surgery. Pericystectomy, choledochotomy, removal of remaining daughter cysts from the common bile duct, and sutures of left hepatic duct were performed. The patient recovered fully after the surgery. One of the possible complications of the liver hydatid cysts is the communication between cyst and the biliary tree. Such communications are usually asymptomatic, but symptoms can also mimic acute cholangitis and jaundice, which may lead to the misdiagnosis of the patient's condition.- - - - - - - - - - ranking = 0.25keywords = tree (Clic here for more details about this article) |
6/15. Hepatic hydatid cysts with biliary, and peritoneal rupture and transdiaphragmatic migration.Hydatid disease is a parasitic infection that most commonly involves the liver. Imaging plays a vital role in the diagnosis of this disease. rupture of the cyst can give rise to a wide spectrum of complications. We describe a case of hepatic hydatid cyst with rupture into the biliary tree, right pleural cavity and dissemination into the peritoneal cavity, with associated splenic hydatid cysts. MRI may be a useful non-invasive diagnostic tool in such disseminated cases to define the complete extent of the disease.- - - - - - - - - - ranking = 0.25keywords = tree (Clic here for more details about this article) |
7/15. Controversy in the management of cholangitis secondary to hydatid daughter cysts.A 36 year old Cypriot woman, resident in the U.K. since the age of three years, presented with pyrexia, jaundice and upper abdominal pain. On ultrasound examination the biliary tree was dilated, contained sludge and a cystic lesion was present in the liver. An endoscopic cholangiogram showed multiple filling defects in the bile duct which were not felt to be removable endoscopically and a nasobiliary drain was therefore inserted. On resolution of the cholangitis with drainage and antibiotics a laparotomy was performed. The right lobe of the liver was largely replaced by a multiloculated cyst and the bile duct contained multiple hydatid daughter cysts. A right hepatectomy was performed with t-tube drainage of the evacuated bile duct. She made an uneventful recovery and has had no problems on subsequent follow up. histology confirmed an intrabiliary rupture of a hydatid liver cyst. cholangitis secondary to daughter cysts is a rare but recognised complication of hydatid liver cysts. Management of hydatid liver cysts by formal resection is controversial but may be preferable in this situation.- - - - - - - - - - ranking = 0.25keywords = tree (Clic here for more details about this article) |
8/15. Non-surgical endoscopic trans-papillary treatment of ruptured echinococcus liver cyst obstructing the biliary tree.Previous reports showed that surgery is the only method of treating liver hydatid cysts that have ruptured into the biliary system. We report a case of obstructive jaundice due to spontaneous rupture of a liver hydatid cyst into the biliary system, which was treated non-surgically by endoscopic papillotomy and extraction of daughter cysts from the biliary system, insertion of a nasobiliary tube for drainage and injection of scolicidal hypertonic saline, into the biliary system. Clear resolution of the obstruction, disappearance of daughter cysts and a decrease in the size of the hepatic cyst was shown by ERCP, ultrasound and CT scan. We believe that this new method is safe, effective and has a lower incidence of mortality, morbidity and recurrence than surgery, which it should replace whenever possible.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
9/15. Caustic sclerosing cholangitis. A complication of the surgical treatment of hydatid disease of the liver.In five patients, sclerosing cholangitis developed after the surgical treatment of hydatid cyst of the liver. The cyst communicated with the biliary tree, and a scolicidal solution (2% formaldehyde in two patients and 20% sodium chloride in three) was injected into the cyst. cholangiography showed strictures affecting the intrahepatic biliary tree in two and both the intrahepatic and extrahepatic biliary tree in three. Sclerosing cholangitis in these patients was likely to result from the caustic effect of the scolicidal solution having diffused from the cyst into the biliary tree. We propose to designate this entity "caustic sclerosing cholangitis". Because of the risk of this complication, and the unproved efficacy of intracystic injection of a scolicidal solution in preventing the dissemination of the parasite, we recommend that this maneuver be abandoned in the surgical treatment of hydatid disease of the liver.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
10/15. rupture of a hydatid cyst of the liver into the biliary tract.rupture of a hydatid cyst into the biliary tract occurs in 5% to 10% of patients with hydatid disease of the liver. The communication between the hydatid cyst cavity and the biliary tree may produce intermittent or progressive obstructive jaundice. The presence of such jaundice complicates the diagnosis since it resembles other biliary disorders such as stone or infection. We treated six patients with hepatic hydatid cysts, four with minute fissures and two with wide ruptures into the biliary tract. The pathophysiologic mechanisms, diagnostic procedures and treatment are discussed.- - - - - - - - - - ranking = 0.25keywords = tree (Clic here for more details about this article) |
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