title: Hydatid embolism from a thoracic aortic pseudoaneurysm presenting as gangrenous toes.
abstract: 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.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir 190011, India.
authors.forename: Abdul Majeed
authors.initials: AM
authors.lastname: Dar
authors.forename: Nadeem Ulnazeer
authors.initials: NU
authors.lastname: Kawoosa
authors.forename: Abdul Gani
authors.initials: AG
authors.lastname: Ahangar
authors.forename: Mukand Lal
authors.initials: ML
authors.lastname: Sharma
authors.forename: Zahur
authors.initials: Z
authors.lastname: Hussain
authors.forename: Mohammad Akbar
authors.initials: MA
authors.lastname: Bhat
authors.forename: Farooq Ahmad
authors.initials: FA
authors.lastname: Ganai
mesh_terms: 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