Echinococcal cyst. Echinococcosis of the liver: treatment, causes, symptoms, prevention

Echinococcosis is a helminthiasis from the class of cestodoses, as a result of which the echinococcal cyst arises in the lungs, kidneys, liver and other organs or tissues. Echinococcosis of the liver is caused by the introduction and maturation in it of larvae of tapeworms.

Causes of the disease

The determining factor of human infection with echinococcosis is its contact with the dog (the carrier of parasites), which can get the disease when eating meat wastes. Another potential culprit for infection of dogs can be the results of hunting - the affected organs or carrion of wild animals.

In humans, the infection mostly comes from unwashed hands. Infection from the dog can occur through its coat or tongue. Other animals can likewise be spontaneous egg transmitters and acquire them also from contact with a sick dog.

There is also the possibility that a person can purchase echinococcosis by eating fruits, vegetables and forest berries that have not been washed or have not been processed. Water from natural lakes also serves as a source of infection.

Echinococcal cyst can also appear in people working in sheep areas. This sheared sheep, shepherds, shepherds and those who contact these people (members of their family).

Signs of echinococcosis

Indicators of this disease are pain in the right upper quadrant, swelling of the liver, nausea. From the onset of infection to the discovery of the first symptoms, several years pass, sometimes even decades. Manifestations of echinococcosis are caused by the location, volumes, rates of cyst growth and its influence on nearby organs and tissues.

In some cases, the malaise can pass without any signs, and it can be accidentally detected during the manufacture of ultrasound or an X-ray. The disease often begins with the usual symptoms - a long subfebrile temperature, weight loss, general weakness, allergic reactions.

For the most part, the echinococcal cyst is initially located in the liver. The factor is the properties of blood circulation: the outflow of blood from the intestine goes to the portal vein, the blood is cleansed by the liver. The ingestion of echinococcus into the organ is called liver echinococcosis.

The indicators of liver echinococcosis are:

• Shortness of breath as a result of localization of diaphragm mobility;
• Pain in the right side;
• nausea and vomiting;
• Spontaneous jaundice (with squeezing of the bile ducts);
• Enlargement of the liver.

How is the echinococcal cyst of the liver removed?

Treatment by own forces of such a disease as echinococcosis of the liver is simply impossible. Although in very rare cases self-healing occurs, associated with the death of larvae. If a cyst, born of echinococcus, is found, then there is no drug therapy that would eliminate the parasite. A ruptured cyst indicates the need for immediate surgery.

By surgical intervention, the entire cyst is removed. If it is in a layer of liver tissue, then completely remove it is impossible because of the possibility of organ damage. In this situation, remove the chitinous wall of the cyst and draw its contents. Then the cyst itself is removed, since there is no chance of its rupture and separation of the parasite. If the cyst is successfully removed, the area of its binding is disinfected and sewn.

Surgery for the liver is performed to completely remove the cyst with its membrane and contents, so that nothing is in the organ itself, the abdominal and thoracic cavity. With a deep disposition or severe lesion, the membrane remains. The operation and its scope of work are determined by the size of the cyst and the problems that it delivered. If the cyst is located in the marginal location, then it is removed together with the capsule. In such a surgical procedure, laser removal of the echinococcal cyst can be used.

Types of operations

If there is multiple echinococcosis of the liver, large cysts, then its resection is done. When one large cyst is detected, an operation is performed on Spasokukotsky or Bobrov, under which an internal echinococcectomy takes place.

In order not to interfere with the infection of the cyst, the membrane is not removed, and its cavity is treated with preparations from parasites, for example, formalin, iodine or alcohol.

If the cyst is located under the diaphragm, and because of surgery, a huge cavity appears, then it is tightened using the method of Pulatov or Delbe or covering the formed cavity with a piece of diaphragm.

If there is a breakthrough of the cyst in the bile ducts, then an urgent operation is performed. Remove the walls and cysts from the affected areas of the biliary tract. In such a situation, the drainage of the bile ducts is inevitable.

In the event that a cyst ruptures into the abdominal cavity, then an urgent operation is done. During this process, cysts and capsules are removed, which are found in the bronchi, abdominal cavity and pleural area. Semi-closed and closed echinococcectomy is performed. In severe situations, they lead an open echinococcectomy.

With massive liver echinococcus, it is important to perform a surgical intervention before problems arise. Operation on the liver can be performed in 2-3 processes with an interval of two weeks to three months.

Mortality in echinococcus is between 1 and 5% of infected people. There may also be relapses if the cyst ruptured.

Prevention

The infection of pets and people is based on procedures performed by medical and veterinary services. A regular inspection of domestic and service dogs for helminths, especially in unfavorable localities, their therapy, the lulling of stray animals, and the control of meat in slaughterhouses should be carried out constantly.

What is necessary?

Regularly conduct hygiene of the population (dog breeders, livestock keepers, hunters and their families), keep dogs clean, constantly wash their hands after talking to them, and before meals, prohibit children from contacting homeless animals, washing vegetables and berries, drinking only disinfected Water.

Echinococcal cyst of the lung

Disease in the early stages is little manifested and is detected by X-ray examination of the lungs in the form of an oval silhouette with exact lines. In the hemogram indicate eosinophilia.

In the formed degree of unstretched cyst, a persistent and severe cough is noted, shortness of breath, easing of breathing at the site of the parasite, pain in different directions in the chest, movement of the mediastinal organs, and a decrease in the percussion sound. Radiography shows in the lungs a huge rounded shadow with certain contours, which changes shape with respiratory excursions of the diaphragm.

The third stage of lung echinococcosis has a serious severity of pathological development and the process of complications. Symptoms of constriction of large vessels and mediastinal organs are observed, deformation of the chest is noted, dyspnea and hemoptysis appear. When death of echinococci occurs inflammation of the cyst with a special clinical symptomatology of the pleura or lung.

Opening of the cyst in the passage of the bronchi is accompanied by the departure of a considerable amount of vivid excretions with the daughter bladder of echinococci with blood veins. If suppuration of the cyst opens, purulent-haemorrhagic sputum appears, and poisoning is also observed. Disclosure of the cyst in the cavity of the membrane provokes the appearance of exudative pleurisy and anaphylactic shock. X-ray examination shows a cavity with a horizontal liquid surface, not strongly manifested perifocal infiltration. Such infiltration is detected if echinococcal cysts are suppressed.

Treatment

Use the operating therapies (remove the cyst from the cuticle capsule, remove the lung). The prognosis is quite serious, with bilateral flow and secondary echinococcosis - sad.

Echinococcosis of the kidney

Echinococcal cyst of the kidney to date is rare, mainly in agricultural areas. The malaise is caused by the helminth of Taenia echinococcus. Distributors of the causative agent are pets - dogs and cats. As a rule, one kidney is affected, in rare cases - two. Echinococcosis of the liver affects the population of the age category from 20 to 40 years, especially women.

The helminth egg enters the kidney by lymphogenous or hematogenous way, most often to the cortical thickness.

Therapy and prognosis

Treatment for the most part is organ-preserving and operative. The most reliable and effective operation is an internal one-stage echinococcotomy. Nephrectomy is also done.

Prevention of echinococcosis requires sanitary and educational procedures to familiarize people with threatening infection from pets, executive sanitary and veterinary surveillance of slaughterhouses.

After operative therapy the prognosis is positive.

Echinococcosis of the spleen

Parasitic cysts of the spleen are often produced by echinococci. The duration of the ailment can last for 15 years and more. By the degree of development of the parasite, the surrounding organs of the abdominal cavity are moved away, the tissue of the spleen is necrotic.

Such a disease is not easy to detect. Echinococcal cyst of the spleen is accompanied by severity in the left hypochondrium, disorders or constipation, minor blunt pains, nausea after eating, allergic reactions. When palpation is set enlarged spleen. Large bubbles can burst, which often leads to death from the accompanying organ rupture.

With an active parasite, there are often signs of allergies - hives, itching, and others. When complicating the spleen echinococcosis, a cyst can break up or its suppuration with clinical expressions of the disease.

Analysis of stool, unfortunately, does not reveal the presence of parasites. The diagnosis is based on X-ray and ultrasound examination, in which multi-chambered bubbles are noticeable.

Treatment

The most effective way to treat a spleen cyst is a laparoscopic operation. Echinococcal cyst can be operated by several methods:

• Complete removal of the spleen;
• The opening of the cyst and the extraction of its contents, the cleaning of the cavity;
• Excision of the affected area of the spleen;
• Removal of the spleen cyst with its wall and contents;
• Clipping of the cyst shell.

The operation of a laparoscopic type in the cyst of the spleen is a usual method of therapy, which makes it possible to remove the source of the disease without leaving a trace. Removal of the spleen cyst is performed with the help of precision instruments and the introduction of a special camera. The duration of the operation is 1.5-2 hours. Then for a period of time there are painful feelings, but for a short period of time the patient completely goes to the amendment.