hepatic hydatid cyst
Introduction
Introduction to liver hydatid cyst Hepatic hydatid cysts are more common in pastoral areas, South America, Southern Europe and Australia are related to shepherds, Iran and Iraq are related to camels, and Canada and Alaska may be related to reindeer. China's Inner Mongolia, Northwest China, Western Sichuan, Tibet and other regions are more common. This disease is also called hepatic hydatidosis, which is caused by the invasion of the liver by the mites of Echinococcus granulosus. basic knowledge The proportion of illness: 0.0021% Susceptible people: more common in young and middle-aged Mode of infection: contact spread Complications: anaphylactic shock
Cause
Cause of liver hydatid cyst
Invaded by the sputum of Echinococcus granulosus.
The human liver hydatid cyst is the asexual stage of the human intermediate host. The main host of this aphid is a dog, a fox or a wolf. The intermediate host is a sheep, a cow, a horse, a pig and a human. This insect is parasitic on a dog. Small intestine villi, adult worms continue to discharge the shell-protected six-hook scorpion, which is discharged with the feces and adheres to the dog's hair or wool. People or other intermediate hosts can be infected by swallowing the contaminated water or food. Digestion of the stomach or upper small intestine, the six hooks are shelled out, through the gastrointestinal wall into the portal vein, most stay in the liver, a few escape to the lungs and other organs, the hydatid in the early stages of the formation of various organs The hydatid cyst, which is the inner capsule behind it, and the fibrous envelope formed by the intermediate host tissue is the outer capsule. The inner capsule is divided into the outer layer and the inner layer, the outer layer is called the keratin membrane, and the inner layer is the inner layer. The hair growth layer, the hair growth layer produces the hair sac, the head section, the ascus, the sun sac. When the worm with the worm infected, the viscera of the cow or other intermediate host is eaten by the dog, fox or wolf, the parasite completes its life cycle. .
Prevention
Hepatic hydatid cyst prevention
1. Extensively carry out propaganda on knowledge of echinococcosis in animal husbandry areas; eliminate wild dogs and strengthen the management of domestic dogs.
2, children do not play dogs; prevent dog dung pollution grassland, feed, water, prevent herd disease, strengthen slaughter and cure, dead sheep body should be buried or burned.
3. Pay attention to personal hygiene; protect water sources and do a good job in environmental sanitation.
Complication
Hepatic hydatid cyst complications Complications anaphylactic shock
1. The escape of cyst fluid leads to allergies.
2. Anaphylactic shock.
3. The anterior segment enters the abdominal cavity to form a secondary hydatid cyst.
Symptom
Hepatic hydatid cyst symptoms Common symptoms Cyst cystic mass jaundice abdominal pain abdominal distension hepatomegaly
Clinical manifestations are not obvious, more common in young and middle-aged, early can be asymptomatic, with the enlargement of cysts can be paralyzed and upper abdominal mass, abdominal distension, abdominal pain, such as located in the right upper liver, showing diaphragmatic elevation, may have respiratory symptoms, many The patient had symptoms of allergic reaction. A few cases could cause jaundice due to cyst compression. There were also cholangitis or sepsis in the bile duct. If you penetrate the chest, you may have respiratory symptoms or bronchial biliary fistula. The main signs are upper abdominal sac. Sexual mass, located in the upper part of the swollen only hepatomegaly, patients with complications can appear corresponding signs.
Examine
Examination of liver hydatid cysts
1. The intradermal test of the hydatid cyst fluid (Cassoni test) is a specific immune reaction by filtering the non-infected hydatid cyst fluid to the head section, and after autoclaving, it is used as a stock solution, generally 1:1000. 1:100, 1:10 isotonic saline dilution 0.1ml, starting from low concentration, intradermal test on the forearm flexion side, 15 minutes after observation, local red papules, red diameter >1cm positive, if positive The reaction appears after 6 to 24 hours, which is a delayed reaction, and still has diagnostic value. The positive rate of this test is 75% to 95%, but there is a false positive.
2. The positive rate of complement fixation test can reach 70%-80%.
3. Blood test to check for increased eosinophils.
4. B-mode ultrasonography can be found in the liver area, and the location and size of the cyst can be determined. The diagnosis of hepatic alveolar echinococcosis should be combined with the history and the Casson test.
5. Hepatic nucleus scanning diameter > 2 ~ 3cm, liver can show space-occupying lesions.
6. X-ray examination showed that the liver shadow increased, the right side of the transverse sac was raised or bulged, the liver area may show shadow or calcification, and the anterior hepatic cyst may show signs of gastrointestinal pressure.
7. CT, selective celiac angiography is helpful for differential diagnosis.
Diagnosis
Diagnosis and identification of hepatic hydatid cyst
1 Congenital hepatic cyst: no history of pastoral living, ultrasound showed that the cyst wall was extremely thin and clear, and the hydatid skin test was negative.
2 Liver abscess: no history of pastoral history and often history of dysentery or purulent disease, ultrasound showed that the liquidity of the occupational boundary is not clear, clinical history of inflammation or performance, negative for the worm skin test, but with infected liver hydatid The cyst is easily confused with it, and the worm skin test is the main basis for identification.
