Project description:Hydatid infection of the heart is rare and there is always the lethal hazard of cyst perforation. We present an 18-year-old male from Kashmir valley who was admitted to the emergency department of our hospital with fever and chest pain for the last 4 days. Using echocardiography and cardiac tomography (CT), cardiac Echinococcosis was diagnosed. The results of surgical treatment of cardiac Echinococcosis were better than the conservative strategy. Surgical excision was performed. The patient had an uneventful recovery.
Project description:IntroductionThe hydatid cyst (HC) of the right ventricle (RV) is an extremely uncommon and a serious location that can cause sudden death following pulmonary embolism, obstruction of the valvular orifice or anaphylactic shock.Case presentationWe report a case of a 14 years-old girl with a HC of the RV. Surgical excision of the HC under Cardiopulmonary bypass (CPB) was successful in managing this rare case.Clinical discussionCardiac HC is extremely rare. It represents only 0.5-2% of all hydatid cases. However, RV location is very severe. It has a tendency to rupture intracavitarily and causes sudden death in 30% of cases. Its diagnosis is based on echocardiography, computed tomography scan and magnetic resonance imaging. The surgical treatment under CPB with anthelmintic therapy seems to improve the prognostic outcomes.ConclusionCardiac HC must be always suspected in endemic countries, especially in patients with a family history of HC.
Project description:INTRODUCTION:Hydatid cyst is a parasitic disease caused by Echinococcus granulosus, most commonly seen in the liver and lungs. The hydatid cyst is rarely seen in the heart and iliofemoral region, representing less than 2% of all cases. In this article, we report our cases of hydatid cysts in unusual loci. METHODS:Between 2015 and 2018, 6 rare cases of hydatid cysts were diagnosed at the Cardiovascular Surgery Department of Harran University. Four of these patients had cardiac localization and two patients had their cysts located in the iliofemoral region, extending to the pelvic zone. All patients were female. Three patients had no other organ involvement. One patient with cardiac hydatid cyst underwent normothermic cardiopulmonary bypass + total pericystectomy + Cooley-like aneurysmectomy. Total pericystectomy was performed in three other patients with intrathoracic locus by normothermic cardiopulmonary bypass. Two patients who were referred to our clinic with palpable iliofemoral mass were evaluated with appropriate imaging methods and diagnosed accordingly. Multiple iliofemoral cysts were managed with pericystectomy and drainage by a single incision made over the inguinal ligament. CONCLUSION:Hydatid cyst disease can develop in cardiac chambers and inguinal region with or without hepatic or pneumatic involvement. Normothermic cardiopulmonary bypass can be safely used in patients with cardiac hydatid cysts, and capitonnage similar to ventricular aneurysm repair in patients with a widely involved cystic lesion can be very useful for the protection of ventricular functions.
Project description:IntroductionHydatid disease is endemic in farming areas but occurs worldwide. The most common site of disease is liver. Hydatid disease of the spleen is a rare condition. Worldwide incidence of splenic hydatid is 0.5-4%. Surgery is the mainstay of treatment. The standard treatment is open total or partial splenectomy.Presentation of caseA 28 year-old female patient was referred to our institution, after coincidental sonography finding. On abdominal examination, there was no sensitization, and there was no resistance or rebound.Ultrasound showed an enlarge spleen; an abdominal CT confirmed the presence of a splenic cyst at the lower pole of the spleen of 7 cm in diameter, no other organ involvement. The biological confirmation was made by indirect hemagglutination. Spleen-sparing surgery was performed. Macroscopic and microscopic examination of the specimen confirmed Hydatid cyst. The patient was discharged from hospital on the seventh postoperative day with a prescription for albendazole (2 × 400 mg/day) for three months.Discussion and conclusionThe rarity of primary splenic hydatid disease poses a diagnostic challenge for clinicians, the disease should be considered in differential in every patient in endemic areas with cystic lesion of spleen until proved otherwise, it may be detected incidentally or present with non-specific complaints, preservation surgery should always be tried to avoid post splenectomy infection, especially in young patients.
Project description:Hydatidosis commonly affect the liver and lungs but in rare cases, it can involve heart tissue. A 42-year-old man from urban areas of Khorasan Razavi province, northeastern Iran, was referred to the cardiac clinic with palpitation, and atypical chest pain in 2018. Large pericardial effusion, reduced left ventricle systolic function was found. A cystic-like lesion was also seen in inter-ventricular septum in echocardiography and high-resolution computed tomography (HRCT). Urgent cardiac surgery was done because of echocardiographic evidence of tamponade. Although the serologic analysis was negative for hydatidosis, surgical excision of cyst and the subsequent histopathological findings revealed a hydatid cyst. In endemic areas, hydatidosis should be considered in differential diagnosis of any cystic-like lesions, even if the serological analysis is negative.
Project description:BackgroundWe report on a 21-year-old patient with a giant symptomatic hydatid cyst of the interventricular septum, to whom a staged management approach was employed. Induction medical therapy led to a reduction in the size of the cyst, which was then completely removed via surgical excision.Case presentationA 21-year-old male Caucasian, with main complaints of fatigue and palpitations, was referred to our Centre due to a cystic formation in his left ventricle. The workup consisted of transthoracic echocardiography and cardiac magnetic resonance, which revealed a huge hydatid cyst in an active stage of disease, occupying the basal and mid part of the interventricular septum. Due to the size of the lesion and lack of viable myocardium in the affected area, the patient was declared inoperable and medical therapy was initiated. Serial echocardiography revealed a significant reduction in the size of the lesion and degradation to transitional and inactive stage, after which successful surgical excision of the cyst was performed. In the course of the medical treatment, the patient experienced sustained ventricular tachycardia causing loss of consciousness, which did not reoccur after surgical excision.ConclusionMedical therapy can result in the degradation of a giant heart hydatid cyst, enabling surgical excision. Heart hydatid cyst can lead to potentially lethal arrhythmia irrespective of its size and stage, which does not reoccur after successful surgical excision.
Project description:Hydatid disease is a parasitic infection by the larval stage of the tapeworm Echinococcus granulosus. It affects liver, lungs and rarely other organs. Medical imaging provide the basis for diagnosis. This case report describes an extremely rare location of cardiac hydatid cyst in the right ventricle of the heart. We describe a 23-year-old woman who presented with shortness of breath and productive cough. Laboratory investigations showed marked eosinophilia and anemia. Chest radiography and abdominal ultrasonography were unremarkable. Cardiac computed tomography (CT) identified two well-defined fluid densities in the right ventricle without contrast enhancement. A transthoracic echocardiography (TTE) showed two cystic lesions in the right ventricular cavity that was attached to the interventricular septum. Hydatid cyst was the most likely diagnosis followed by the possibility of a congenital cardiac cyst. An open-heart surgery with cardiac cystectomy was performed. Post-operative analysis of the resected specimens showed multiple hydatid cysts with living scolices of Echinococcus granulosus. The patient recovered uneventfully and was discharged on oral albendazole.
Project description:"Hydatid cyst" which also known as cystic Echinococcosis is a parasitic infestation caused by the larval stage of Echinococcus granulosus. The liver and lungs are the most sites to occur. Incidence in muscles is exceptionally rare. We report a case of a 36-year-old female presented with an uncomfortable mass in the upper medial of her right thigh without any presence of other symptoms. She lived in a rural area in Manbij, which is an endemic area of hydatid cysts in Syria. She was a shepherdess; therefore she had direct contact with sheep and dogs. Ultrasound examination showed a cyst located between adductor longus muscle and gracilis muscle closed to the deep femoral artery. The patient was treated with pharmaceutical therapy for a week before cystectomy, which was done under general anesthesia. The cyst was dissected between the fibers of adductor longus muscle from the lateral side and fibers of the gracilis muscle from the medial side. The cyst with all its layers was resected. Musculoskeletal Echinococcosis is a rare disease, because of intramuscular growth of cysts is restricted by muscle's contractility, the muscles are undesirable habitat for Echinococcus granulosus and because of the hepatic barrier role. Many cysts are revealed by complications such as nerve compressions, infections simulating an acute abscess or a malignant tumor. Hydatid cyst present as mass of soft tissue, particularly in endemic areas, as a result of contaminated water. MRI considered the best technique in the diagnosis.
Project description:Spleen is an unusual location for hydatid cyst. Here we report a case of primary splenic hydatid cyst in a 41-yr-old Iranian woman from Yasuj, southwest of Iran. The patient had been admitted to Shahid Beheshti Hospital because of abdominal pain. Abdominal sonography revealed a hypoechoic lesion of 150 X 130 mm in the spleen, suggestive of hydatid cyst. Splenectomy was performed for the patient and surgical interventions revealed a hydatid cyst occupying most of splenic parenchyma. She was discharged on the 5 day of her operation. Postoperative diagnosis and confirmation of hydatid cyst was done by histopathological, molecular and serological approaches. Histopathological evaluation revealed the classical laminated layer of hydatid cyst. DNA was extracted from a part of cyst and PCR amplified. Sequencing and analysis of PCR product revealed that the isolate has the most similarity with G1 strain of Echinococcus granulosus. Patient's serum was positive for IgG anti-hydatid cyst antibodies, using antigen-B ELISA.
Project description:We describe a case of multifocal relapsing hydatid cyst following multilevel thoracic corpectomy and 360° instrumentation surgery. A 41-year-old male patient presented with cord compression and paraplegia due to a multiseptated cystic lesion at T10-11 level. The cyst was excised with a combined anterior and posterior approach and 360° stabilization was performed. The patient received albendazole for 1 year after the surgery. The patient presented with paraparesis 5 years after the surgery. Cystic lesions between C2-T1 and T10-11 were detected on the spinal MRI and the patient was operated with removal of the lesions on both levels and adjuvant local 20% hypertonic saline application. The patient received albendazole for the postoperative 6 months. After 3 months from the surgery, the patient's paraparesis recovered. There was no recurrence after 2 years from the last surgery.