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Primary pelvic hydatid cyst: a case report.

Parray FQ, Wani SN, Bazaz S, Khan SU, Malik NS - Case Rep Surg (2011)

Bottom Line: This is a case report of a young man who presented to us as a case of hypogastric pain and frequency of micturation.General physical examination and radiological evaluation confirmed a multiloculated pelvic swelling.Patient was subjected to laparotomy which confirmed the diagnosis of a primary pelvic hydatid disease.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Sher-i-Kashmir Institute of Medical Sciences, J&K, Srinagar 190011, India.

ABSTRACT
This is a case report of a young man who presented to us as a case of hypogastric pain and frequency of micturation. General physical examination and radiological evaluation confirmed a multiloculated pelvic swelling. Patient was subjected to laparotomy which confirmed the diagnosis of a primary pelvic hydatid disease. Patient was put on chemotherapy after surgery and is doing well on follow up.

No MeSH data available.


Related in: MedlinePlus

Intraoperative picture of a pelvic hydatid after complete mobilization.
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Related In: Results  -  Collection


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fig2: Intraoperative picture of a pelvic hydatid after complete mobilization.

Mentions: A 23-year-old man presented with complaints of dull pain in hypogastric region and frequent micturition for the last 4 months. General physical examination of the patient was unremarkable. Abdominal examination was normal. Digital rectal examination revealed a large, smooth, symmetrical mass lying anterior to the rectum. Ultrasonography of abdomen revealed a large hypoechoic mass with echogenic septations in the pelvis posterior to the urinary bladder. Contrast-enhanced computerized tomogram (CECT) of abdomen and pelvis revealed a huge pelvic cyst 8 × 7 cm in diameter (Figure 1) lying between the urinary bladder and the rectum in the rectovesical pouch. Provisional diagnosis of primary pelvic hydatid disease was made, but hydatid serology was not suggestive of the disease. Radiological examination of chest (chest X-ray PA view) was normal. CECT of the chest is done in our setup only if chest X-ray shows a doubtful lesion in order to decrease the financial burden of the treatment. Exploratory laparotomy revealed a large hydatid cyst in the rectovesical pouch (Figure 2). There were no similar cystic masses in any other abdominal viscera (Figure 3). Cyst was completely excised without any spillage after packing the surrounding area with 1% cetrimide-soaked sponges. Final diagnosis was confirmed by pathological examination. Postoperative period was uneventful. Patient was put on 3 cycles of albendazole therapy; dose of the albendazole was adjusted according to the body weight of the patient. Each cycle of albendazole therapy was of one month duration. After each cycle patient was advised a holiday period of 2 weeks, and in that holiday period liver function and complete blood counts were assessed which in both holiday periods were normal, and subsequently 2nd and 3rd cycles were completed. This is a routine protocol in our department on all patients operated for hydatid cysts. I personally do not advocate laparoscopy in suspected lesions of hydatid disease because of the concern of spillage and it still is not a gold standard for such cysts. The histopathology confirmed it as a hydatid cyst caused by echinococcus granulosus. In spite of the fact that hydatid disease is quite common in our setup, we never encounter a hydatid disease secondary to echinococcus multilocularis.


Primary pelvic hydatid cyst: a case report.

Parray FQ, Wani SN, Bazaz S, Khan SU, Malik NS - Case Rep Surg (2011)

Intraoperative picture of a pelvic hydatid after complete mobilization.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3350145&req=5

fig2: Intraoperative picture of a pelvic hydatid after complete mobilization.
Mentions: A 23-year-old man presented with complaints of dull pain in hypogastric region and frequent micturition for the last 4 months. General physical examination of the patient was unremarkable. Abdominal examination was normal. Digital rectal examination revealed a large, smooth, symmetrical mass lying anterior to the rectum. Ultrasonography of abdomen revealed a large hypoechoic mass with echogenic septations in the pelvis posterior to the urinary bladder. Contrast-enhanced computerized tomogram (CECT) of abdomen and pelvis revealed a huge pelvic cyst 8 × 7 cm in diameter (Figure 1) lying between the urinary bladder and the rectum in the rectovesical pouch. Provisional diagnosis of primary pelvic hydatid disease was made, but hydatid serology was not suggestive of the disease. Radiological examination of chest (chest X-ray PA view) was normal. CECT of the chest is done in our setup only if chest X-ray shows a doubtful lesion in order to decrease the financial burden of the treatment. Exploratory laparotomy revealed a large hydatid cyst in the rectovesical pouch (Figure 2). There were no similar cystic masses in any other abdominal viscera (Figure 3). Cyst was completely excised without any spillage after packing the surrounding area with 1% cetrimide-soaked sponges. Final diagnosis was confirmed by pathological examination. Postoperative period was uneventful. Patient was put on 3 cycles of albendazole therapy; dose of the albendazole was adjusted according to the body weight of the patient. Each cycle of albendazole therapy was of one month duration. After each cycle patient was advised a holiday period of 2 weeks, and in that holiday period liver function and complete blood counts were assessed which in both holiday periods were normal, and subsequently 2nd and 3rd cycles were completed. This is a routine protocol in our department on all patients operated for hydatid cysts. I personally do not advocate laparoscopy in suspected lesions of hydatid disease because of the concern of spillage and it still is not a gold standard for such cysts. The histopathology confirmed it as a hydatid cyst caused by echinococcus granulosus. In spite of the fact that hydatid disease is quite common in our setup, we never encounter a hydatid disease secondary to echinococcus multilocularis.

Bottom Line: This is a case report of a young man who presented to us as a case of hypogastric pain and frequency of micturation.General physical examination and radiological evaluation confirmed a multiloculated pelvic swelling.Patient was subjected to laparotomy which confirmed the diagnosis of a primary pelvic hydatid disease.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Sher-i-Kashmir Institute of Medical Sciences, J&K, Srinagar 190011, India.

ABSTRACT
This is a case report of a young man who presented to us as a case of hypogastric pain and frequency of micturation. General physical examination and radiological evaluation confirmed a multiloculated pelvic swelling. Patient was subjected to laparotomy which confirmed the diagnosis of a primary pelvic hydatid disease. Patient was put on chemotherapy after surgery and is doing well on follow up.

No MeSH data available.


Related in: MedlinePlus