Echinococcus granulosus cysts in the liver: management with percutaneous drainage.
Twenty-one hepatic Echinococcus granulosus cysts (maximal diameter, 7.5 cm +/- 4.0) in 12 patients were aspirated and irrigated with hypertonic (20%) saline under sonographic guidance. All patients had signs and symptoms of a hepatic mass caused by the cysts, which had a prominent fluid component that appeared anechoic or hypoechoic, with marked enhancement of back wall echoes. The amounts of cyst fluid aspirated and of hypertonic saline used were 190 mL +/- 240 and 120 mL +/- 90, respectively. Separation of the endocyst from the pericyst and nonviability of scoleces were observed in all cysts. Mean hospital stay was 4.0 days +/- 3.4. Serial sonographic examinations revealed high-level echoes in the cyst cavity (heterogeneous echo pattern), which ultimately became uniformly echogenic (pseudotumor). After follow-up of 14.0 months +/- 5.5, maximal cyst diameter decreased to 4.1 cm +/- 3.1 (P less than .001). One patient died of unrelated causes; the remaining 11 patients experienced relief of symptoms and a decrease in liver span.
Khuroo
M S
MS
Department of Gastroenterology, Institute of Medical Sciences, Srinagar, Kashmir, India.
Zargar
S A
SA
Mahajan
R
R
D000328:Adult; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging* / Q000276:immunology / Q000628:therapy; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D011677:Punctures / Q000009:adverse effects / Q000379:methods; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D007507:Therapeutic Irrigation; D014463:Ultrasonography
D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012462:Saline Solution, Hypertonic