Case Report: Role of Interventional Radiology in the Management of Patients with Alveolar Echinococcus: Successful Management of Three Cases
| Autor: | Devrim Akinci, Okan Akhan, Turkmen Ciftci, Merve Gulbiz Dagoglu-Kartal, Cigdem Ozer |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Biliary cirrhosis Liver transplantation Echinococcus multilocularis Young Adult Intestinal mucosa Echinococcosis Virology Humans Medicine biology medicine.diagnostic_test business.industry Bile duct Interventional radiology Articles Middle Aged Jaundice biology.organism_classification medicine.disease Surgery Infectious Diseases medicine.anatomical_structure Female Parasitology medicine.symptom business Liver abscess |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene. 98:1403-1407 |
| ISSN: | 1476-1645 0002-9637 |
| Popis: | Alveolar echinococcus (AE) is an infestation by Echinococcus multilocularis. The parasite found in the intestinal mucosa of the definitive host, which is red fox 60% of the time, produces eggs dispersed through feces. The oncospheres in the eggs ingested by the intermediate hosts penetrate the intestinal wall and develop into multilocular cysts. The intermediate hosts are rodents most of the time, but it can occasionally be humans as well.1 The liver is the most commonly affected organ. Biliary tracts, portal vein, and hepatic veins are usually involved.2–4 The disease is clinically silent for many years and the parasite grows infiltratively as a malignant tumor.3,5,6 In untreated or inadequately treated AE, mortality is more than 90% within 10–15 years.7 Partial hepatectomy or liver transplantation is the first choice of treatment.8–10 However, because of the silent growth pattern, the disease is usually diagnosed at an unresectable stage. In those cases, invasion of the bile ducts and vessels and necrosis in the center of the lesion lead to severe complications, such as cholangitis, liver abscesses, portal hypertension, Budd–Chiari syndrome, biliary cirrhosis, or superimposed infections affecting morbidity or mortality.11 Mass resection, formerly recommended to decompress the biliary tree,12 later was reported not to offer any advantages while the success of chemotherapeutics and percutaneous and endoscopic interventions was demonstrated.11,13–20 In 2010, an expert consensus was published in which interventional procedures were favored over palliative surgery. The main indications for percutaneous bile and abscess drainage were stated as the liver abscess formation secondary to infection of necrotic lesions, jaundice due to bile duct obstruction with or without cholangitis, and bilioma formation.21 Herein, we present the outcomes in three cases that have been managed and followed up for various indications in our interventional unit. |
| Databáze: | OpenAIRE |
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