[Myocutaneous latissimus dorsi sliding flap in reconstruction of the lower thoracic wall in chronic fistula caused by cystic echinococcosis of the liver].
We report the successful treatment of a 47-year-old man who had a 22-year history of chronic discharge from a hepatic echinococcal cyst. Before treatment in our unit there had been 8 previous attempts to control the fistula. By means of a right thoracoabdominal incision (with resection of the 7th and 8th ribs) it was possible to perform a cystectomy with subsequent marsupialisation of the residual cyst wall to the skin. However, after 2 weeks subsequent treatment with maximal Albendazol therapy there was still a big persistent cavity which required further débridement. This resulted in resolution of the infection and allowed a definitive closure of the big cavity and the thoracoabdominal wall using a myocutaneous latissimus dorsi flap. The patient's subsequent course has been uneventful with no recurrence of the fistula.
Universitätklinik für Viszerale und Transplantationschirurgie, Inselspital Bern.
W
W
Mouton
W
W
Schweizer
J C
JC
Zuber
H
H
Tschopp
L H
LH
Blumgart
D003646:Debridement / Q000379:methods*; D004444:Echinococcosis, Hepatic / Q000601:surgery*; D004445:Echinococcosis, Pulmonary / Q000601:surgery*; D005402:Fistula / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D013524:Surgical Flaps / Q000379:methods*
Myokutaner Latissimus-dorsi-Verschiebelappen zur Rekonstruktion der unteren Thoraxwand bei chronischer Fistel wegen zystischer Leberechinokokkose.