Dataset Information

Primary cerebral echinoccocosis in a child: Case report - Surgical technique, technical pitfalls, and video atlas.

ABSTRACT:

Background

Hydatid disease is a life-threatening parasitic infestation caused by Echinococcus granulosus. Infection with E. granulosus typically results in the formation of hydatid cysts in the liver, lungs, kidney, and spleen. Primary intracranial hydatid cyst disease is extremely rare. Here, we are reporting an unusual case of Echinococcus, where the only identifiable lesion was a hydatid cyst in the brain without liver or lung involvement. We are also providing a description for the surgical technique used to remove the cyst, highlighting the possible surgical pitfalls.

Case description

The patient is a 13-year-old male with a history of progressive headache for 1 month. Intracranial hydatid cyst was suspected based on computed tomography and magnetic resonance imaging findings. The cyst was delivered without rupture using hydrostatic dissection (Dowling's technique), and pathological analysis confirmed the diagnosis. Postoperatively, the patient showed marked neurological improvement and all signs and symptoms resolved.

Conclusion

Intracranial hydatid cyst is very rare. Nevertheless, it should always be considered as a differential diagnosis in cerebral cystic lesions, especially in children. The surgical technique used to remove the cyst appears to be safe. However, several precautions must be applied intraoperatively to avoid the catastrophe of cyst rupture.

SUBMITTER: Altibi AM

PROVIDER: S-EPMC5154201 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Publications

Primary cerebral echinoccocosis in a child: Case report - Surgical technique, technical pitfalls, and video atlas.

Altibi Ahmed M A AM Qarajeh Raed A H RA Belsuzarri Telmo A B TA Maani Walid W Kanaan Tareq M A TM

Surgical neurology international 20161121 Suppl 37

<h4>Background</h4>Hydatid disease is a life-threatening parasitic infestation caused by <i>Echinococcus granulosus</i>. Infection with <i>E. granulosus</i> typically results in the formation of hydatid cysts in the liver, lungs, kidney, and spleen. Primary intracranial hydatid cyst disease is extremely rare. Here, we are reporting an unusual case of <i>Echinococcus</i>, where the only identifiable lesion was a hydatid cyst in the brain without liver or lung involvement. We are also providing a ...[more]

PMID: 27999716

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Project description:ImportanceIn any surgical procedure, various aspects of technique may affect patient outcomes. As new procedures enter practice, it is difficult to evaluate the association of each aspect of technique with patient outcomes.ObjectiveTo examine the associations between technique and outcomes in laparoscopic sleeve gastrectomy.Design, setting, and participantsIn this cohort study of bariatric surgery programs participating in a statewide surgical quality improvement collaborative, 30 surgeons submitted intraoperative videos from representative sleeve gastrectomies performed on 6915 patients with morbid obesity. These videos were reviewed by blinded peer surgeons on key technical elements, and 605 reviews were linked to sleeve gastrectomy outcomes of all of the surgeons' patients from January 1, 2015, to December 31, 2016.ExposuresSurgeons' technical approaches to 5 controversial aspects of laparoscopic sleeve gastrectomy: dissection of the proximal stomach, sleeve caliber, sleeve anatomy, staple line reinforcement, and leak testing.Main outcomes and measuresThe 30-day outcomes were rate of postoperative hemorrhage and staple line leak. The 1-year outcomes were percentage of total weight lost and reflux severity (Gastroesophageal Reflux Disease Health-Related Quality of Life instrument).ResultsA total of 30 surgeons submitted 46 videos of operations performed on 6915 patients (mean [SD] age, 45.4 [11.7] years; 5494 [79.5%] female; 4706 [68.1%] White). Complete dissection of the proximal stomach was associated with reduced hemorrhage rates (higher ratings for complete mobilization of fundus were associated with a decrease in hemorrhage rate from 2.1% [25th percentile] to 1.0% [75th percentile], P = .01; higher ratings for visualization of the left crus were associated with a decrease in hemorrhage rate from 1.5% to 0.94%, P = .006; and higher ratings for complete division of the short gastrics were associated with a decrease in hemorrhage rate from 2.8% to 1.2%, P = .03). The reduction in hemorrhage rates came at the expense of higher leak rates (higher ratings for complete mobilization of fundus were associated with an increase in leak rate from 0.05% [25th percentile] to 0.16% [75th percentile], P < .001; higher ratings for visualization of the left crus were associated with an increase in leak rate from 0.1% to 0.2%, P = .003; and higher ratings for complete division of the short gastrics were associated with an increase in leak rate from 0.02% to 0.1%, P = .01). Surgeons who stapled more tightly to the bougie had smaller decreases in reflux than those who stapled less tightly (-2.0 to -1.3 on a 50-point scale, P = .002). Staple line reinforcement (buttressing and oversewing) was associated with a small (2 of 1000 cases) decrease in hemorrhage rates. Staple line buttressing was also associated with a similarly small increase in leak rates (1 of 1000 cases). Leak testing was associated with a statistically insignificant change in the staple line leak rate (0.16%-0.22%, P = .47).Conclusions and relevanceVariations in surgical technique can be measured by video review and are associated with differences in patient outcomes.

Dataset Information

Primary cerebral echinoccocosis in a child: Case report - Surgical technique, technical pitfalls, and video atlas.

Background

Case description

Conclusion

Publications

Primary cerebral echinoccocosis in a child: Case report - Surgical technique, technical pitfalls, and video atlas.

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