Hydatid embolism from a thoracic aortic pseudoaneurysm presenting as gangrenous toes.
Cystic echinococcosis (hydatid cyst), caused by Echinococcus granulosus, has worldwide distribution and poses a health problem in endemic areas. Embolization of hydatid cysts into the vascular tree is an unusual manifestation of the disease. The hydatid embolism results from spontaneous or traumatic rupture of the cyst, and rare case reports of this kind are not well documented in the literature. We report a case of a hydatid embolism from a ruptured hydatid in a pseudoaneurysm of the thoracic aorta. A 45-year-old woman presented with gangrenous changes of the toes of her right foot. After embolectomy, the histopathology of the embolus was doubtful about its being blood clots around hydatid membranes. Postoperatively, computed tomography (CT) of the chest revealed a pseudoaneurysm of the descending thoracic aorta. Definitive surgery for the pseudoaneurysm was done during a second operation. Numerous hydatid cysts were evacuated from the pseudoaneurysm. This report emphasizes the need for an early diagnosis and treatment of echinococcosis before disabling and life-threatening complications occur.
Dar
Abdul Majeed
AM
Department of Cardiothoracic and Vascular Surgery, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir 190011, India.
Kawoosa
Nadeem Ulnazeer
NU
Ahangar
Abdul Gani
AG
Sharma
Mukand Lal
ML
Hussain
Zahur
Z
Bhat
Mohammad Akbar
MA
Ganai
Farooq Ahmad
FA
D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000601:surgery; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000601:surgery; D000818:Animals; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000601:surgery; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000601:surgery; D004443:Echinococcosis / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000601:surgery; D048209:Echinococcus granulosus / Q000302:isolation & purification*; D017128:Embolectomy; D004617:Embolism / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000601:surgery; D005260:Female; D005734:Gangrene; D006801:Humans; D008875:Middle Aged; D012086:Reoperation; D014034:Toes / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome