Case Report: Percutaneous Treatment of Multiple Echinococcal Cysts Presenting as Abdominal Palpable Mass
Author(s) -
Chiara Tersigni,
Alessandro Semeraro,
Marcello Caremani,
Elisabetta Venturini,
Claudio Defilippi,
Maurizio de Martino,
Luisa Galli
Publication year - 2018
Publication title -
american journal of tropical medicine and hygiene
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.015
H-Index - 151
eISSN - 1476-1645
pISSN - 0002-9637
DOI - 10.4269/ajtmh.18-0464
Subject(s) - albendazole , medicine , echinococcus granulosus , abdomen , radiology , abdominal mass , abdominal pain , echinococcosis , magnetic resonance imaging , percutaneous , cyst , ultrasound , surgery , biology , zoology
We report the case of an adolescent Moroccan girl with abdominal pain and palpable mass in the upper right side of the abdomen. In the emergency department, an abdominal ultrasound showed hepatomegaly and eight active liver cysts, compatible with cystic echinococcosis. Serology for Echinococcus granulosus confirmed the diagnosis. Other sites of localization were excluded. Treatment involved albendazole combined with puncture, aspiration, injection, re-aspiration, performed only for the most medial cysts. Periodical follow-up with abdominal ultrasound and with abdominal magnetic resonance imaging showed a progressive involution of all cysts. The treatment with albendazole was stopped after, overall, 6 months, and monthly ultrasound scan were planned as follow-up. In case of hepatic cysts, E. granulosus should be excluded, especially in children from endemic countries. A multidisciplinary approach with pediatric infectious disease specialists, radiologists, and surgeons is fundamental for disease management.
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