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Quistectomia por laparoscopia en hidatidosis complicada

Journal: Alianzas y Tendencias BUAP (Vol.5, No. 18)

Publication Date:

Authors : ;

Page : 8-13

Keywords : hydatid cyst; laparoscopic cystectomy; scolicidal solution; antiparasitic therapy;

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Abstract

Introduction: Hydatidosis, also known as echinococcosis, is the infection produced by the larvae (hydatids) of the species of the genus Echinococcus. It is a zoonotic parasitosis caused by cestodes of the species E. granulosus and E. multilocularis, which produce unilocular and multilocular or alveolar hydatidosis, respectively. According to geographical distribution, E. granulosus is the most relevant cystic form in Spain. The E. granulosus life cycle needs two host to complete. The host becomes infected by ingesting herbivorous viscera containing the hydatid cyst. The natural history implies the rupture of the cyst in 50-90% of the cases, giving rise to anaphylactic shock due to its high antigenic load. The diagnosis is mainly indirect through serological and radiological techniques. Imaging tests help identify the location, size, and number of the lesions. The treatment of hydatidosis consists of the surgical removal of the cyst using invasive techniques or laparoscopy, punction-aspiration-injection-reaspiration (PAIR) technique under ultrasound control and / or pharmacological treatment. Objective: To describe a clinical case of hydatid cyst and its drug-surgical management. Case description: Patient with radiological diagnosis, by ultrasound and computerized axial tomography, of multivesicular cystic lesion admitted to the Hospitalization Unit for clinical-surgical management of hydatid cyst. Extraction is performed by laparoscopy, after preparation with scolicidal solution to decrease the risk of anaphylactic shock due to cyst rupture. Favorable evolution of analytical parameters. Antiparasitic drugs, albendazole associated with praziquantel, were used as support measures before surgery. Conclusions: Surgical removal by laparotomy is the choice to control parasitic infection and reduce associated risks. The use of scolicidal solutions minimizes the risk of anaphylactic shock due to rupture of the cyst. The combination of PAIR and albendazole offers greater efficacy, a lower recurrence rate, less morbidity and mortality, and a shorter hospital stay. The association of praziquantel exerts a synergistic effect.

Last modified: 2020-05-23 09:01:13