Hydatid cysts in the outpatient practice of a surgeon

Introduction. The hydatid form of echinococcal disease of EB is a rather urgent problem and over time the degree of its significance does not decrease. The main target organ is the liver, according to various authors, it accounts for up to 84% of all clinical observations. The probability of lung tissue involvement in the pathological process is 15%. Echinococcosis of other organs and tissues, as well as a combined lesion occurs in 25% of cases. Lesion of echinococcosis of muscle tissue is observed in 0.7–0.9% of all cases. The main method of treatment at present is surgery with its various options such as echinococcectomy, pericystectomy, resection.

Objective. To demonstrate on the available clinical example the feasibility of using surgical treatment of EB of rare localization in the area on the anterior abdominal wall.

Materials and methods. The result of treatment of a patient with echinococcosis of rare localization on the anterior abdominal wall is presented. The diagnosis is established in accordance with the available clinical recommendations. The examination was carried out using a standard set of clinical metols, and included: collection, analysis of complaints, as well as an anamnesis of life and disease. Standard clinical and biochemical studies were performed.

Results. The hydatid form of echinococcosis with localization on the anterior abdominal wall is a rather rare pathology. However, treatment issues and diagnostic difficulties are quite relevant for doctors of various specialties. As a result of this clinical observation and the treatment, the patient recovered; after 17 months there was no data for a relapse of the disease.

Conclusion. 1. Timely diagnosis of hydatid echinococcosis of any localization is fundamental in improving the results of treatment of this category of patients. 2. A multidisciplinary approach in the selection of therapeutic tactics, namely the appointment of chemotherapeutic effects before and after surgery, an active surgical one, allows to achieve a good therapeutic result.

1. Arakelyan R.S., Kuzmichev K.Yu., Kuzmichev V.Yu., Arakelyan A.S., Zolotenkova A.N., Glebova A.A., Kuzmichev B.Yu. Clinical and epidemiological characteristics of echinococcosis in the Astrakhan region. In: Pozdnyakova M.A. (ed.). Preventive medicine as a scientific and practical basis for maintaining and promoting public health. Nizhny Novgorod; 2014. (In Russ.)

2. Arakelyan R.S., Galimzyanov Kh.M., Shendo G.L., Okunskaya E.I., Aleksashina D.S., Lunina I.O. Clinical and epidemiological aspects of human echinococcosis in the Astrakhan region. In: Feral herd infections in modern medical practice. 2016. (In Russ.)

3. Arakelyan R.S., Galimzyanov Kh.M., Mustafin R.D., Karpenko S.F., Kurbangalieva A.R., Arakelyan A.S. Clinical and epidemiological features of human echinococcosis in the Astrakhan region. Aktuanaya infektologiya = Actual Infectology. 2015;(4):38–41. (In Russ.) Available at: http://nbuv.gov.ua/UJRN/akinf_2015_4_9.

4. Sultanova R.S., Medzhidov R.T., Medzhidov S.R., Khamidov T.M. Reasons of recurrence of abdominal echinococcosis and its prevention. Astrakhanskiy meditsinskiy zhurnal = Astrakhan Medical Journal. 2016;11(3):125–130. (In Russ.) Available at: http://astmedj.ru/archive/2016/3/prichiny-retsidivaabdominalnogo-ekhinokokkoza-i-ego-profilaktika/.

5. Bazarova Sh.Yu., Marazhabova D.I., Menglieva I.A., Tadzhieva M.A., Tukhtamurod Z.Z. Ways to improve the treatment of patients with liver echinococcosis. Molodoy uchenyy = Young Scientist. 2018;(10):40–42. (In Russ.) Available at: https://moluch.ru/archive/196/48734/.

6. Kalmykov E.L., Gaibov A.D., Sadriev O.N., Safarova A.N. Primary Muscle Hydatidosis of the Lumbar Region. Novosti Khirurgii = Surgery News. 2016;24(6):610–616. (In Russ.) doi: 10.18484/2305-0047.2016.6.610.

7. Mamedov A.M., Guseynov G.G., Ragimov V.A., Ragimli Sh.I. Fistulojejunostomy in external biliary fistulas after the echinococcectomy (the clinical case). Astrakhanskiy meditsinskiy zhurnal = Astrakhan Medical Journal. 2012;1(7):141–144. (In Russ.) Available at: http://astmedj.ru/archive/2012/1/fistuloenterostomiya-pri-naruzhnykh- zhelchnykh-svishchakh-posle-ekhinokokkektomii-klinicheskiysluch/.

8. Odishelashvili G.D., Pakhnov D.V., Odishelashvili L.G. Method for treating residual cavity following marsupialization and open echinococcectomy. INVENTION RU 2551189 C1. 2014. (In Russ.) Available at: https://patenton.ru/patent/RU2551189C1.

9. Kuchin Yu.V., Pakhnov D.V. Laparoscopically assisted surgery of hepatic hydatid disease. Abstracts of the 16th Congress of the Russian Society of Endoscopic Surgeons. Endoskopicheskaya khirurgiya = Endoscopic surgery. 2013;1(2):51. (In Russ.) Available at: http://xn----9sbdbejx7bdduahou3a5d.xn--p1ai/upload/tezis_endo_2013.pdf.

10. Mikhin I.V., Kosivtsov O.A. Hydatid disease of the left hip. Khirurgiya. Zhurnal imeni N.I. Pirogova = Pirogov Russian Journal of Surgery. 2015;(7):97–100. (In Russ.) doi: 10.17116/hirurgia2015797-100.

11. Pakhnov D.V., Odishelashvili Givi D., Odishelashvili L.G., Serdyukov V.G. Combined approach to treatment of gidate echinococcosis of the liver. Astrakhanskiy meditsinskiy zhurnal = Astrakhan Medical Journal. 2017;12(4):13–20. (In Russ.) Available at: http://www.astmedj.ru/archive/2017/4/kombinirovannyy-podkhod-k-lecheniyu-gidatidnogoekhinokokkoza-pecheni/.