Case of duodenal obstruction caused by a giant echinococcal cyst of the liver

Abstract

Echinococcosis is one of the most common parasitic diseases in humans. Most of the literature reviews and reports indicate an increase in the incidence of liver echinococcosis, a significant spread of pathology beyond endemic regions, and an increase in the incidence of new cases in non-endemic areas, with 75% of cases being children and individuals and young people, children under the age of 14 account for about 15% of cases in the structure of the general morbidity of echinococcosis. Reducing parasitic morbidity, especially among children, is an essential reserve for reducing the burden of illness and prolonging life expectancy. In the majority of cases, the liver is affected – 75%, lungs – 15%; in rare cases, the brain, bones and heart (2%), kidneys (2%), skin, spleen (6%). In endemic areas, 10–15% of patients have a parasitic lesion of two organs. During the last 20 years there has been an increase in the number of complicated forms of echinococcosis in the liver, with a frequency of 84.6%. Relapse of the disease is observed in 54% of cases. Despite significant progress in the diagnosis and treatment of the disease, the frequency remains high before and after the surgical complications, the rate of relapse of the disease reaches 54%, in some regions it reaches an index of 38.8%. Modern diagnostic methods allow with high precision to carry out laboratory verification of the disease, topical distribution and morphological changes in the affected organs. In treatment, depending on the stage of the disease, the size of the parasitic cysts are used different methods: mininvasive (percutaneous puncture-aspiration echinococcectomy under the control of ultrasound or CT, Videotraco and video-laparoscopic interference), traditional echino cocectomy, pericisectomy, resection of the liver. Issues of differential diagnosis of echinococcosis, studying the possibilities of modern visualization methods in planning the volume of surgical intervention on the liver are relevant. It requires separate study of the choice of the optimal method of surgical intervention, the method of its implementation, the place and the possibilities of using mininavazivnyh techniques. The article presents the clinical case of a giant echinococcal cyst that caused acute duodenal obstruction. The description of such clinical cases in the available literature is not found.