ABSTRACT
STUDY DESIGN: A case report. OBJECTIVE: This is an unusual presentation of recurrent hydatid disease. Spillage of a hydatid cyst was previously reported in a symptomatic case of primary spinal hydatid disease. However, we did not find any examples of spontaneous discharge of hydatid cyst fluid in an asymptomatic case in the literature. SUMMARY OF BACKGROUND DATA: Bone hydatid cysts occur in 1% to 2.5% of all patients with hydatid cyst disease, whereas 50% of bone hydatidosis cases are spinal. Diagnosis is difficult and patients usually present with neural compression symptoms. Surgery and antihelmintic medicine administration are considered as the treatments of choice. METHODS: In this report, a 35-year-old male patient, who underwent surgical and antihelmintic medical treatment 2 years previously, had a leaking cyst without neurologic symptoms. The patient underwent excision of multiple parasacral cysts from a posterior approach. Medical antihelmintic treatment was used after surgery. RESULTS: The postoperative period was uneventful. Follow-up MRI scans were performed at 6, 12, and 18 months after surgery. The few residual anterior perisacral cysts had, in fact, become smaller. CONCLUSION: The recurrence period of spinal hydatid disease may be silent without any neurologic deficits or pain; the only clinical manifestation may be leakage from a cyst. Curative therapies remain unlikely, but periodic follow-up MR images are advisable for early diagnosis of recurrence in order to obtain effective treatment.
Subject(s)
Bone Cysts/surgery , Echinococcosis/surgery , Sacrum/surgery , Spinal Diseases/surgery , Surgical Wound Dehiscence/surgery , Adult , Albendazole/therapeutic use , Animals , Anthelmintics/therapeutic use , Bone Cysts/parasitology , Bone Cysts/pathology , Echinococcosis/diagnostic imaging , Echinococcosis/pathology , Echinococcus , Humans , Lumbar Vertebrae/parasitology , Lumbar Vertebrae/pathology , Lumbar Vertebrae/surgery , Magnetic Resonance Imaging , Male , Neurosurgical Procedures , Radiography , Reoperation , Sacrum/parasitology , Sacrum/pathology , Secondary Prevention , Spinal Diseases/parasitology , Spinal Diseases/pathology , Surgical Wound Dehiscence/parasitology , Surgical Wound Dehiscence/pathology , Treatment OutcomeABSTRACT
A 43 years old female patient suffered ventricular resection (Billroth II) because of tumor. On the 11. postoperative day an Ascaris lumbricoides (with the length of 20 cm) was creeping out of the site of the draining tube onto the abdominal wall. Enteral parasites are very rare and strange reasons for postoperative duodenal suture insufficience but our case may deserve some attention considering the well known spreading of Ascaris infections.
