Hidatidosis pancreática en una niña de 5 años / Pancreatic echinococcosis in a 5-year-old girl

La hidatidosis pancreática representa el 0,2-0,6 % de los casos, siendo la población pediátrica la de mayor riesgo. Las lesiones suelen localizarse en cabeza del páncreas (50-58 %); la localización en cuerpo y cola del páncreas se encuentra en el 24-34 % y el 19 %, respectivamente. Dada la posibilidad de complicaciones, suele realizarse tratamiento quirúrgico. Se sugiriere indicar albendazol antes y después del acto quirúrgico por los riesgos de ruptura y diseminación de los protoescólices. Se presenta el caso de una niña de 5 años de edad con dolor abdominal progresivo y lesión quística en páncreas compatible con hidatidosis en la ultrasonografía. En la tomografía computada se observa compresión de la vía biliar. La hemoaglutinación indirecta fue negativa. Presentó elevación de la bilirrubina total, con franco predominio de bilirrubina directa, y aumento de enzimas hepáticas. Se realizó laparotomía exploradora, colecistectomía y destechamiento del quiste. Evolucionó favorablemente, continuó con albendazol durante 3 meses luego de la cirugía.

Pancreatic echinococcosis accounts for 0.2­0.6% of cases, with the pediatric population being at a higher risk. Most commonly, pancreatic lesions occur in the head of the pancreas (50­58%); and in the body and tail in 24­34% and 19% of cases, respectively. Given the potential complications, surgery is usually performed. Albendazole is recommended before and after the surgery due to the risks for rupture and dissemination of protoscolices. Here we describe the case of a 5-year-old girl with progressive abdominal pain and cystic lesion in the pancreas compatible with echinococcosis in the ultrasound. The computed tomography showed bile duct compression. Indirect hemagglutination was negative. She had elevated total bilirubin, with a clear predominance of direct bilirubin, and high liver enzymes. Exploratory laparotomy, cholecystectomy, and unroofing of the cyst were performed. The patient had a favorable course and continued with albendazole for 3 months after the surgery.

Hydatid cyst in the cervical spinal cord complicated by potentially life-threatening difficult airway: a case report / Cisto hidático na medula cervical complicada por via aérea difícil com potencial risco de vida: relato de caso

Abstract Hydatid cyst in the cervical region is an extremely rare condition that can create challenges for anesthesiologists. Timely recognition of difficult airway and preparing the management plan is crucial to avoid life-threatening complications such as hypoxic brain damage. We describe a case of difficult airway management in a patient with massive cervical hydatid cyst. We used a low-dose ketamine-propofol sedation and lidocaine spray for local oropharyngeal anesthesia. Muscular relaxants were not used, and spontaneous breathing was maintained during intubation. Recognition, assessment, and perioperative planning are essential for difficult airway management in patients with cervical hydatid cyst.

Resumo O cisto hidático na região cervical é uma condição extremamente rara que pode criar desafios para os anestesiologistas. O reconhecimento oportuno das vias aéreas difíceis e a preparação do plano de manejo são cruciais para evitar complicações com risco de vida, como danos cerebrais hipóxicos. Descrevemos um caso de difícil controle das vias aéreas em um paciente com cisto hidático cervical maciço. Utilizamos sedação com cetamina-propofol em baixa dose e spray de lidocaína para anestesia local orofaríngea. Relaxantes musculares não foram utilizados e a respiração espontânea foi mantida durante a intubação. O reconhecimento, a avaliação e o planejamento perioperatório são essenciais para o manejo difícil das vias aéreas em pacientes com cisto hidático cervical.

La técnica de Mabit para la hidatidosis: Una revisión centenaria / Mabit’s technique for hydatidosis: A centennary revisit

El trabajo publicado por Sebastián Mabit en Francia para describir la que llamó su técnica para el tratamiento quirúrgico de los quistes hidatídicos, y la previa tesis de uno de sus practicantes, tienen un grupo de enfermos en común operado por el primero en el Hospital Francés de Buenos Aires a fines del siglo XIX. Las diferencias en la descripción de las operaciones realizadas provocan dudas sobre el origen de tal técnica, que se exponen aquí.

The paper published by Sebastián Mabit in France describing what he called his technique for the surgical treatment of hydatid cysts, and the previous thesis of one of its trainees, share a group of patients operated by Mabit in the Hospital Francés of Buenos Aires at the end of the 19th century. There are some doubts about the origin of such technique due to differences in the description of the operations. These differences are described below.

Intracoronary hydatid cyst resulted in coronary artery disease in a young patient

Abstract Among all cystic echinococcosis cases, only 0.5%-2% exhibit a cardiac involvement. Only 10% of these become symptomatic. Considering the long time interval between the start of infestation and symptoms to occur, it is hard to diagnose cystic echinococcosis. When detected, even if it is asymptomatic, intramyocardial hydatid cyst requires surgical intervention due to risks of spontaneous rupture and anaphylaxis. In literature, no case of hydatid cyst located in the coronary arterial wall has been reported. Twenty-two-year-old male patient with previous history of pulmonary cystic echinococcosis was referred to us with typical symptoms of coronary artery disease. Coronary cineangiography revealed proximal left diagonal artery (LAD) occlusion. Pre-operative transthoracic echocardiography of the patient planned to undergo coronary artery bypass grafting unveiled an intracoronary calcified cystic mass. In operation, the calcified cystic mass with well-defined borders and size of 2x2 cm located within wall of proximal segment of the LAD artery was excised and double bypass with left internal thoracic artery (LITA) and great saphenous vein grafts to the LAD and first diagonal arteries, respectively, was done. Pathological analysis of the mass revealed it to be an inactive calcified hydatid cyst. Echinococcal IgG-ELISA test was positive. 12-week oral albendazole treatment (2x400 mg/day) was launched postoperatively and the patient was discharged on 7th postoperative day.

Embolismo arterial agudo como forma de presentación clínica inicial de una hidatidosis diseminada: reporte de un caso / Acute arterial embolism as the clinical presentation of a disseminated hydatidosis: case report

La hidatidosis es una zoonosis producida por el parásito Echinococcus granulosus. En el ciclo zoonótico del parásito, el hombre es un huésped intermediario y sufre la enfermedad tras la ingesta de alimentos y agua contaminados por la materia fecal de animales infectados. En Argentina, la enfermedad constituye un problema importante de salud pública. Suele manifestarse con compromiso hepático y pulmonar. La afectación de otros órganos, que incluyen el corazón, es infrecuente.

Hydatidosis is a parasitic infection caused by the Echinococcus granulosus larvae, transmitted by the ingestion of infected food, characterized by the formation of cysts in vital organs. In Argentina, the disease is spread throughout the territory, constituting an important public health issue. The disease usually affects the liver and lungs. The affection of other organs is rare, and even more uncommon the affection of the heart. We present the case of a disseminated hydatidosis in a pediatric patient, whose initial clinical manifestation was an acute arterial embolism of the right limb caused by the rupture of a hydatidic cardiac cyst.

Hidatidosis Cardiaca Primaria / Primary cardiac hydatidosis

Cardiac hydatidosis without involvement of extracardiac organs is an uncommun condition. We report a case of a 20 years old female without any prior disease, she consult for progressive dyspnea and palpitations. Echocardiogram and cardiac MRI shows cystic lesion in apical intraventricular septum suggestive of hydatid cyst. No other organs were affected. The patient underwent surgery with successful removal of hydatid cyst and medical treatment with Albendazole, after that, the patient remains asymptomatic.

A concomitant intramyocardial and pulmonary hydatid cyst: a rare case report

Abstract Cardiac hydatid cyst is an uncommon but potentially fatal disease. In cystic Echinococcus humans are an accidental host. Liver and lungs are the most frequently involved organs. Herein a unique case of intramyocardial hydatid cyst of left ventricle along with pulmonary hydatid cyst in a 38-year-old lady is reported. Surgical removal of the cardiac hydatid cyst was done with the aid of cardiopulmonary bypass followed by removal of pulmonary hydatid cyst.

Adolescente con inestabilidad lumbosacra por presencia de quiste hidatídico: reporte de caso / An adolescent with lumbosacral instability due to the presence of a hydatid cyst: a case report

RESUMEN La hidatidosis, causada por el Echinococcus granulosus, afecta a la columna vertebral en 0,5-2% del total de casos, siendo la columna sacra una ubicación rara, típica de personas en edad adulta. Se reporta el caso de un varón de 14 años oriundo de Juliaca (Puno, Perú) quien presentó lumbalgia crónica y síndrome de cauda equina. Atendido inicialmente en Juliaca, fue trasladado al Hospital Edgardo Rebagliati Martins (Lima, Perú) con el diagnóstico de tumoración sacra. En la resonancia magnética se mostró una tumoración multiquística con lisis del L5 y S1 e inestabilidad. El tratamiento quirúrgico fue una laminectomía L5-S2 y extracción de múltiples quistes de hidátide más estabilización lumbopélvica con tornillos transpediculares. En el posoperatorio se recetó albendazol (15 mg/kg/d) por el periodo de seis meses. Se debe considerar al quiste hidatídico dentro del diagnóstico diferencial cuando existan lesiones quísticas en la columna vertebral, sobre todo en regiones endémicas como el Perú.

ABSTRACT Hydatidosis, caused by Echinococcus granulosus, affects the spinal column in 0.5-2% of all cases, with the sacral column being a rare location typically observed only in adults. The case is reported of a 14-year-old boy from Juliaca (Puno, Peru) who presented with chronic lower back pain and cauda equina syndrome. He was initially attended to in Juliaca, and then transferred to the Hospital Edgardo Rebagliati Martins (Lima, Peru) with a diagnosis of sacral tumor. In magnetic resonance imaging, a multicystic tumor was seen with L5 and S1 lysis and instability. The surgical treatment was an L5- S2 laminectomy and extraction of multiple hydatid cysts followed by lumbopelvic stabilization with transpedicular screws. Post-operatively, he was prescribed albendazol (15 mg/kg/d) for six months. Hydatid cysts should be considered within the differential diagnosis when there are cystic lesions in the spinal column, particularly in endemic areas such as Peru.

Identification of IgE and IgG1 specific antigens in Echinococcus granulosus cyst fluid

Cystic echinococcosis (CE) is an anthropozoonotic disease with worldwide distribution and is caused by the cestode Echinococcus granulosus. Anaphylactic shock induced by CE rupture is a serious complication especially in patients with hydatid infections, as the resulting leakage of fluid contains highly toxic endogenous antigen. We aimed to isolate and identify the antigens of specific IgE and IgG1 (sIgE and sIgG1) in E. granulosus cyst fluid (EgCF). Crude antigen for EgCF was prepared from E. granulosus-infected sheep liver. Antigens were separated and identified by one-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis (1D SDS-PAGE), two-dimensional gel electrophoresis (2-DE), and immunoblotting. Results of 1D SDS-PAGE and immunoblotting showed that 40.5 kDa protein was the major antigen of sIgE, and 35.5 kDa protein was the major antigen of sIgG1 in EgCF. Results of 2-DE and immunoblotting showed that main antigens of sIgE in EgCF were four proteins with pI values ranging from 6.5 to 9.0 and a molecular weight of 40.5 kDa. Main antigens of sIgG1 in EgCF were five proteins with pI values ranging from 6.5 to 9.0 and a molecular weight of 35.5 kDa. The antigens identified for sIgE and sIgG1 can provide critical insights into cellular and molecular mechanisms underlying anaphylactic shock induced by CE.

Causa rara de distensión abdominal aguda: apertura del conducto pancreático en un quiste hidatídico / A rare cause of acute abdominal distention: opening of the pancreatic duct into hydatic cyst

Introducción. El quiste hidatídico, causado por Echinococcus granulosus, se observa mayormente en el hígado y los pulmones, aunque raramente también puede localizarse en cualquier órgano o tejido blando. En este artículo se presenta el caso de un paciente con quiste hidatídico pancreático con apertura del conducto pancreático en el quiste. A propósito de un caso: Se atendió en nuestra clínica a un niño de 10 años de edad con distensión abdominal significativa y dolor en el epigastrio de 10 días de evolución. La concentración de amilasa sérica era de 3709 U/l y la inhibición de la hemaglutinación para hidatidosis era de 1/160. En la tomografía computarizada de abdomen se observaron dos lesiones separadas y ascitis, un quiste hidatídico de tipo CE2 en la región de la cola del páncreas y un quiste hidatídico de tipo CE1 en el lóbulo izquierdo del hígado. Se realizó el drenaje percutáneo del quiste ubicado en la cola del páncreas y se inició tratamiento con albendazol. Se retiró la sonda de drenaje, y desde ese momento se ha realizado el seguimiento del paciente sin que se observen complicaciones.

Introduction. Hydatid cyst, which is caused by Echinococcus granulosus, is mostly seen in the liver and lungs although it may also rarely be found in any organ or soft tissue. This study presents an interesting case of pancreatic hydatid cyst in which the pancreatic duct opened into this cyst. Case report. A 10-year-old boy presented to our clinic with significant abdominal distension and pain in the epigastric region which had started 10 days previously. Serum amylase level was 3709 U/L and hemagglutination inhibition for hydatid disease was 1/160. At abdominal computed tomography, two separate lesions and ascites were determined, a CE2 hydatid cyst in the region of the tail of the pancreas and a CE1 hydatid cyst in the left lobe of the liver. Percutaneous drainage was applied to the cyst in the pancreatic tail, and the patient was started on albendazole. The drainage catheter was removed, and the patient has since been followed-up on an outpatient basis with no complications.

Epidemiological, clinical and paraclinical study of hydatid cysts in three educational medical centers in 10 years

Background: Echinococcosis or hydatidosis, caused by the larval stage of Echinococcus granulosus [E. granulosus], is an important public health problem in many areas of the world and Iran is a country of endemic situation for hydatidosis In the present study, we evaluated epidemiological, complications and clinical characteristics of hydatidosis at three University Medical Centers in Tehran over a 10-year period

Materials and Methods: This is a descriptive cross-sectional study performed in patients with hydatid cysts. Information about age, gender, number of cysts, organ involvement, morbidity and mortality and relapse were collected from medical records of hydatid patients. Paraclinic information such as CT Scan, MRI, ultrasound, complete blood count, pathological diagnosis and complication of disease were collected

Results: Overall, 81 patients, 35 [43.2%] male and 46 [56.8%] female, who were diagnosed as having hydatid cyst by clinical and radiological findings, with pathologic documentation were studied in three university medical center registries over a 10-year period [2003- 2012] in Tehran. Fourteen patients [17% of cases] had complications resulting from this disease. Patients' age ranged from 5 to 86 years, and the peak prevalence of the disease was between 20 and 40 [34% of cases]

Conclusion: Iran is a country of endemic situation for hydatidosis. Prevalence rate of hydatidosis in Iran was reported to be 0.61-2 in 100000 populations. The highest rate of infection and complications were in patients of 20-40 years age. Clinical examination revealed that abdominal pain was the most common complaint and was present in 51.7% of the cases. Other most common complain were cough, abdominal mass, dyspnea, icterus, chest pain, dyspepsia, back pain and seizure; and it was result of occupying effect of cysts in organs. This is similar with previous studies in Iran[22]

Right ventricular hydatid cyst ruptured to pericardium.

Cardiac hydatidosis is rare presentation of body hydatidosis. Incidence of cardiac involvements range from 5% to 5% of patients with hydatid disease. Most common site of hydatid cyst in heart is interventricular septum and left ventricular free wall. Right ventricular free wall involvement by cyst that ruptured to pericardial cavity is very rare presentation of hydatid cyst. Cardiac involvement may have serious consequences such as rupture to blood steam or pericardial cavity. Both the disease and its surgical treatment carry a high complication rate, including rupture leading to cardiac tamponade, anaphylaxis and also death. In the present report, a 43‑year‑old man with constrictive pericarditis secondary to a pericardial hydatid cyst is described.

Paraparesia secundaria a hidatidosis paravertebral / Paraparesis secondary to paravertebral hidatidosis

La hidatidosis es una zoonosis causada por la fase larval del Echinoccocus. Afecta principalmente a la región mediterránea, Sudamérica, África, Medio-Oriente, Australia y Nueva Zelanda. Afecta principalmente al hígado y al pulmón, aunque puede comprometer cualquier parte del cuerpo ya sea, por inoculación primaria o diseminación secundaria. Se presenta el caso de paciente de 54 años, sexo masculino, con antecedentes de hidatidosis pulmonar izquierda y abdominal subdiafragmática, diagnosticada hace 33 años. Ingresa por cuadro de paraparesia progresiva de extremidades inferiores, disminución de sensibilidad a la altura de T12 y lumbalgia sin otros signos ni síntomas asociados. La Tomografía axial computada mostró lesión tumoral paravertebral izquierda con signos de infiltración y destrucción de costilla y vértebra T12 a nivel de lámina y pediculo izquierdo, junto con lesión de 12 cm paravertebral anterior, con ingreso de quiste a lúmen aórtico, entre T4 y T6. Resonancia nuclear magnética muestra invasión hacia canal medular con signos de compresión. Se realizó laminectomía descompresiva con evacuación de vesículas. La evolución posterior es satisfactoria con recuperación de su paraparesia, logrando la bipedestación a los pocos días. Si bien el compromiso vertebral es raro, este se puede manifestar con dolor y síntomas secundarios a la compresión medular como paraparesia o paraplejia, déficit sensorial, reflejos osteotendíneos alterados, disfunción esfintérica y síndrome de cauda equina. Imágenes como tomografía axial computada y resonancia nuclear magnética, son necesarias para un efectivo diagnóstico y monitorización de la hidatidosis. El tratamiento de elección es la descompresión quirúrgica asociado a antihelmínticos para evitar la recurrencia.

The hydatid disease is a zoonoses caused by Echinoccocus’s larvae stage. The most affected regions are Meditarranea, South America, Africa, Mid West, Australia and New Zealand. Mostly infects the liver and the lungs, but any part of the body can be affected, by primary inoculation or dissemination. We present a case of a 54 years old, male patient, with 33 years history of pulmonary and abdominal hydatid disease. He is hospitalized for progressive paraparesia of lower limbs, paresthesia T12 root nerve and low back pain. Without any other symptoms. The CT scan shows a left paravertebral mass with infiltration signs and destruction of T12 vertebra and rib, and a 12 cm anterior paravertebral tumor with aorta invasion. Magnetic resonance imaging shows invasion of the spinal canal. Descompressive laminectomy was made with evacuation of the vesicles. Patient shows a satisfactory evolution, with a complete recovery of paresthesia and be able to walk. The vertebral hydatid disease is rare, but can be manifested by pain and medular compression symptoms, such a paraparesia, paresthesis, altered tendon reflexes, sphincter dysfunction and cauda equina syndrome. Imaging such a CT scan and Magnetic resonance imaging, are necesary for an effective diagnosis and monitoring of the disease. The treatment of choice is the surgical descompression with the use of antihelminthics in order to prevent the recurrence.

Oclusión arterial aguda asociada a hidatidosis diseminada / Acute arterial occlusion associated disseminated hydatidosis

Hidatidosis o equinococosis son términos usados para denominar a la infestación zoonótica causada por los estadios adulto y larvario (metacéstode) del céstode del género Equinococcus (familia tenidae). El término hidatidosis debe ser aplicado a la infestación por el metacéstode mientras que el de equinococosis a los estadios larvario y adulto. En el Perú existe una alta prevalencia de esta infección siendo el hígado y pulmón los órganos más afectados. Existen factores tanto del agente infeccioso como del hospedero que contribuyen a esta infección, donde el componente inmunológico del hospedero es un punto importante tanto en la infección como en la diseminación. En el presente artículo se reporta un caso de oclusión arterial aguda asociada a hidatidosis diseminada en un paciente de 54 años de edad, natural y procedente de Huancavelica, de inicio súbito con un cuadro de obstrucción arterial aguda; que no mejoró luego de la cirugía con fallecimiento a las 48 horas de la presentación.

Hydatidosis or echinococcosis are terms used to denote the zoonotic infestation caused by adult and larval stages (metacestode) of the cestode from the genus Echinococcus (family tenidae). The term hydatidosis should be applied to the infestation caused by the metacestode while echinococcosis for the larval and adult stages. In Peru there is a high prevalence of this infection, liver and lung being the most affected organs. There are factors from the host and from the infectious agent that contribute to this infection, with the immune component of the host as an important infection and dissemination point. A case of acute arterial occlusion associated with disseminated hydatidosis in a 54 years old patient, born and from Huancavelica, with sudden onset of an acute arterial obstruction is reported. The patient did not improve after surgery and died within 48 hours of presentation.

Hidatidosis cerebral sobreinfectada en la infancia: a propósito de un caso / Overinfected cerebral hydatid disease in childhood: report of a case

La hidatidosis es una enfermedad parasitaria en la que el hombre es un huésped intermediario accidental, portador de la forma larvaria de Echinococcus granulosus. La forma más frecuente de hidatidosis es la hepática, seguida de la pulmonar. La localización en el sistema nervioso central es rara. La gran mayoría de los quistes hidatídicos cerebrales han sido diagnosticados en niños. Los quistes localizados en este sitio presentan diferentes e interesantes características en su evolución y diagnóstico. Las manifestaciones clínicas están en relación a su localización, y al síndrome de hipertensión endocraneana que las lesiones ocasionan por efecto de masa y/o por la hidrocefalia que puedan condicionar. Se presenta el caso de un paciente de 10 años de edad que presenta un cuadro de cefalea, vómitos y hemiparesia braquiocrural izquierda de 48 h de evolución. Fue evaluado con métodos diagnósticos imagenológicos, bioquímicos y serológicos, logrando el diagnostico de hidatidosis cerebral múltiple sobreinfectada. Es intervenido quirúrgicamente, resecando dos quistes hidatídicos de 5 cm en diferentes tiempos quirúrgicos. Se realiza una revisión bibliográfica sobre el tema y se discute sus principales características clínicas, diagnóstico, tratamiento y pronóstico.

Hydatid disease is a parasitic disease in which the man is an accidental intermediate host, carrying the larval form of Echinococcus granulosus. The most common form of liver hydatid disease is followed by the lung. Locating in the central nervous system is rare. The vast majority of cerebral hydatid cysts have been diagnosed in children. Cysts located on this site have different and interesting features in its evolution and diagnosis. The clinical manifestations are related to their location, and intracranial hypertension syndrome that injuries cause by mass effect and / or hydrocephalus that may condition. We report the case of a patient aged 10 years presented symptoms of headache, vomiting and left hemiparesis braquio 48 hours of evolution. It was evaluated with diagnostic imaging methods, biochemical and serological, making the diagnosis of multiple cerebral hydatid superinfected. The patient underwent surgery, resecting two hydatid cysts of 5 cm in different surgical times. We review the literature on the subject and discusses its main clinical features, diagnosis, treatment and prognosis.

Higher Seroprevalence of Hepatitis B Virus Antigen in Patients with Cystic Hydatid Disease than in Patients Referred to Internal Medicine Clinics in Turkey

Turkey remains an intermediate area for prevalence of hepatitis B virus (HBV) surface antigenemia. The sheep-raising areas of Turkey also pose a high risk for cystic hydatid disease (CHD). Both HBV infection and CHD are major public health issues particularly in eastern parts of Turkey; however, there is no data regarding HBV infection in patients who have had CHD. The aims of this study were to evaluate the association between HBV infection and CHD and suggest ways to reduce HBV infection which is still widespread in Turkey. A retrospective study was conducted with 94 adult patients with active CHD referred to the hepatology department, Yuzuncuyil University School of Medicine from December 2010 to December 2012. All subjects came from rural areas of the region and underwent ultrasonography of abdomen which detected CHD of the liver. All the patients were serologically positive for Echinococcus granulosus. The control group consisted of 500 patients (300 men and 200 women) referred to the internal medicine clinics for other reasons. The patients with CHD and in the control group were tested for the existence of HBs antigen according to the standard procedures. The seroprevalence of HBs antigen was significantly higher in patients with active CHD than those in the control group (12.7% vs 5.2%; P=0.0017). Our data indicate that there is significant association between HBV infection and CHD. All patients with CHD should be screened for HBV infection.

Skeletal Manifestations of Hydatid Disease in Serbia: Demographic Distribution, Site Involvement, Radiological Findings, and Complications

Although Serbia is recognized as an endemic country for echinococcosis, no information about precise incidence in humans has been available. The aim of this study was to investigate the skeletal manifestations of hydatid disease in Serbia. This retrospective study was conducted by reviewing the medical database of Institute for Pathology (Faculty of Medicine in Belgrade), a reference institution for bone pathology in Serbia. We reported a total of 41 patients with bone cystic echinococcosis (CE) during the study period. The mean age of 41 patients was 40.9+/-18.8 years. In 39% of patients, the fracture line was the only visible radiological sign, followed by cyst and tumefaction. The spine was the most commonly involved skeletal site (55.8%), followed by the femur (18.6%), pelvis (13.9%), humerus (7.0%), rib (2.3%), and tibia (2.3%). Pain was the symptom in 41.5% of patients, while some patients demonstrated complications such as paraplegia (22.0%), pathologic fracture (48.8%), and scoliosis (9.8%). The pathological fracture most frequently affected the spine (75.0%) followed by the femur (20.0%) and tibia (5.0%). However, 19.5% of patients didn't develop any complication or symptom. In this study, we showed that bone CE is not uncommon in Serbian population. As reported in the literature, therapy of bone CE is controversial and its results are poor. In order to improve the therapy outcome, early diagnosis, before symptoms and complications occur, can be contributive.

Hidatidosis poliquística tropical por Echinococcus vogeli / Polycystic tropical echinococcosis due to Echinococcus vogeli

Antecedentes. Hace 30 años se reconoció que las tumoraciones poliquísticas en 13 pacientes autóctonos de países tropicales sudamericanos eran producidos por una nueva especie de parásitos, el Echinococcus vogeli. Ahora se conocen 200 casos en 12 países (desde Panamá hasta Brasil y Perú). Lugar. Cali, Colombia; Nueva Orleans y Seattle, USA. Diseño. Estudio experimental y retrospectivo. Objetivo. Se presenta esta enfermedad a países con zonas tropicales donde la enfermedad aún es desconocida. Métodos. Se estudiaron 78 pacientes. El curso fue crónico, de quistes abdominales, algunos dolorosos, hepáticos, con o sin cirrosis biliar, asociados a lesiones torácicas y mesentéricas. El 85% se localizó en el hígado y el 14% en el pulmón. El diagnóstico se basó en el examen físico, la radiología, la procedencia rural, el conocimiento de la paca, en la convivencia con perros y en la serológica. Conclusiones. El tratamiento se basa en la cirugía y el albendazol. La equinococosis poliquística tropical por el Echinococcus vogeli representa un problema médico severo en América del Sur, con mortalidad del 29%. Los casos diagnosticados representan una pequeña proporción de las infecciones humanas.

Background. Thirty year ago it was recognized experimentally that polycystic tumors in 13 autochthonous patients from south American countries were produced by a new species: Echinococcus vogeli. As of march 2007, 200 cases were known from 12 countries (from Panamá, Colombia and Venezuela to Brasil and Perú). Places. Cali, Colombia; New Orleans and Seattle, USA. Design. Experimental and retrospective studies. Objective. This disease is presented to the countries with tropical areas, where the illness is steel unknown. Methods. 78 patients were studied. They had cysts, sometime painful, connected with the liver, with or without biliar cirrhosis, associated with pulmonary and mesenteric lesions. 85% in the liver, 14% in the lung. The diagnosis was based in palpation, radiological imaging, rural origin, knowledge of the paca, history of closed contact with dogs and positive serology for echinococcosis. Conclusions. The combination of surgery and albendazol was the most efficient treatment. The tropical polycystic echinococcosis is a severe medical problem in South America with a 29% mortality. The number of diagnosed cases probably only represent a small proportion of the human infections.

Hidatidosis uterina: una localización excepcional / Uterine hydatid cyst: an exceptional location

La hidatidosis es una zoonosis de distribución mundial producida por helmintos del género Echinococcus. En Chile representa un problema de salud pública no resuelto aún en su totalidad. La localización ginecológica es poco frecuente, pero debe considerarse en el diagnóstico diferencial de masas pélvicas, sobre todo, en pacientes con infertilidad. Se presenta un caso clínico de hidatidosis pélvica primaria de origen uterino como hallazgo operatorio. Se discute el manejo y seguimiento.

The hydatid disease is a worldwide distribution zoonotic infection caused by a tapeworm of the genus Echinococcus. In Chile, it is a public health probiem that hasn't been completely solved yet. It is very unlikely to be found in ginecology. Still it has to be considered within pelvic mass study, mostly between infertile patients. We now discuss a surgical finding of a pelvic primary hydatid disease of uterine origin clinical case, the management and follow-up.

Factores que intervienen en la persistencia de la Hidatidosis en la Localidad de El Albardón: un estudio epidemiológico realizado en la prov. de Santiago del Estero: 2005 / Factors that intervene in the persistence of the Hidatidosis in the Locality of The Albardón: an epidemiological study realized in the prov. of Santiago of the Tideland: 2005

La presente investigación permitió analizar los factores epidemiológicos que favorecen la persistencia de la Hidatidosis en El Albardón, provincia de Santiago del Estero. Se realizó un estudio demagráfico constatándose 137 habitantes, se tomó como muestra 100 habitantes (72,9%); variables y resultados: sexo (51% masculino y 49% femenino); edad, 2 a 9 años: 15%, 10 y 19 años: 24%, 20 a 29 años, 30 a 39 años: 19%, 40 a 49 años: 13% y >50 años: 9%, escolaridad, primaria incompleta; 24% primaria completa 47% y escuela secundaria completa 29%; disponibilidad sanitaria, 100% letrina; suministro de agua, bordo; 29%, el pozo-aljibe; 71%, huertas domiciliarias, 51%; animales de granja: 96% de ellos el 97,9% es caprino y ovino, el 76% bovino y 14,6% porcino; tenencia de perros, 96%; faena domiciliaria, 96%, el 87,5% alimenta sus canes con visceras infectadas. El estudio de la Equinococosis canina se realizó detectando coproantígenos por ELISA en 25 muestras recogidas al azar de materia fecal, positivas 32%. La hidatidosis en humanos se detectó con hemaglutinación indirecta (HAI), el 17% fue positivo. Factores de riesgo comunes en la HAI positivos: tenencia de perros 100%, faena domiciliaria 81,3%, alimenta con visceras infectadas a sus canes 81,3%, huertas domiciliarias 52,9%, auga de pozo-aljibe 52,9% y bordo 47,1%...