Repeated Percutaneous Treatment of Massive Hepatic Cystic Echinococcosis in a Child
| Autor: | Boško Desnica, Tomislava Skuhala, Klaudija Višković, Mirjana Balen Topić, Martin Drinković |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Abdominal pain Echinococcosis Hepatic Percutaneous Adolescent medicine.medical_treatment 030231 tropical medicine Liver transplantation Asymptomatic Albendazole 03 medical and health sciences 0302 clinical medicine hepatic cystic echinococcosis percutaneous treatment child medicine Humans Cyst 030212 general & internal medicine Echinococcus granulosus Radiofrequency Ablation biology business.industry Neglected Diseases biology.organism_classification medicine.disease Echinococcosis Surgery Treatment Outcome Pediatrics Perinatology and Child Health medicine.symptom business medicine.drug |
| Zdroj: | Pediatrics. 142(6) |
| ISSN: | 1098-4275 |
| Popis: | Because of mostly asymptomatic cyst growth and often-neglected nonspecific low-grade symptoms, many cases of cystic echinococcosis (CE) caused by Echinococcus granulosus in the pediatric population are diagnosed at school age, in an advanced and even complicated stage. In 2003, after 5 months of intermittent dull upper-right abdominal pain and nausea, a 13-year-old boy was diagnosed with massive liver CE, with ∼20 round-shaped double-walled medium-sized infective cysts, which permeated the whole liver. Because of their wide distribution across the liver tissue and the risky superficial position of some cysts, liver transplantation emerged as the optimal therapeutic option. Despite being described as only an exceptionally used method for CE, we subjected our patient on 4 occasions to a radiofrequency energy thermoablation (RFT) procedure similar to the one used for malignant neoplasms. In total, 9 superficially situated cysts were initially treated with RFT by using a 14-gauge outer needle and a temperature of 70°C for 8 minutes per cyst, and the remaining cysts were treated with the puncture-aspiration-instillation-reaspiration procedure, along with albendazole (15 mg/kg per day) therapy, for a period of 20 months. After 2 years of follow-up, 4 residual small-sized semisolidified cysts were seen in the liver, and the patient showed no signs of relapse. Although not routinely used, RFT, along with puncture-aspiration-instillation-reaspiration and prolonged albendazole therapy, has shown good tolerability and long-term efficacy in the treatment of multiple infective CE, which could suggest the usefulness of the RFT method beyond salvage situations in pediatric patients. |
| Databáze: | OpenAIRE |
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