ABSTRACT
Hydatid cyst disease is an infection most frequently caused by the larval form of a parasite named Echinococcus granulosus. Spillage of hydatid fluid during open surgery has been shown to result in serious anaphylactic reaction. We report a case of 46 years old male with hydatid cyst of liver, who had a sudden onset of intra-operative hypotension, tachycardia, flushing, edema and bronchospasm. He was managed with adrenaline, antihistaminics, steroids, supplementary fluids and vasopressors, and after successful resuscitation, was shifted to ICU for further management. Four days later, he was weaned off from vasopressors and ventilatory support and shifted to the surgical ward. Early diagnosis and intervention are crucial for successful management of the anaphylactic reactions
ABSTRACT
This study was planned to investigate the efficacy of either 99mTc-sestamibi scan or ultrasonography in predicting the operative treatment in patients with primary hyperparathyroidism [PHPT]. Subjects and Method: Thirty patients [25 female, 5 male; mean age: 53 years] being operated for symptomatic primary PHPT were included in this study. Ultrasonography was used in 29 patients while 99mTc-sestamibi scintigraphy was done in 28 patients to localize the hyperfunctioning gland[s]. Standard bilateral neck exploration was done in 6 patients. Although unilateral intervention had been planned for 24 patients, bilateral intervention was performed in 9 of them. Sensitivity of 99mTc-sestamibi was 81%, while that of ultrasonography was 42%. 99mTc-sestamibi localization method led to misleading results in 10/28 [35.7%] patients. False-positive localization and accompanying thyroid pathologies played an important role in determining transition from unilateral to bilateral intervention. Our findings indicate that bilateral intervention remains a successful management option without prior localization in patients with PHPT especially in an endemic goiter region