RESUMO
BACKGROUND: The hydatid disease, or echinococcosis, is endemic in Mediterranean countries, as well as in Australia, Asia, Africa, South America, and Canada. Among its complications is intraperitoneal rupture, a rare form of presentation, with highly variable symptoms. The treatment of choice is surgery plus adjuvant medical treatment in most patients. OBJECTIVE: A case is presented of a patient with disseminated peritoneal hydatidosis manifested as intestinal ischaemia. CLINICAL CASE: A 50-year-old male was admitted to the emergency room with a history of chronic abdominal pain that worsened in the last 24hours. He showed signs of sepsis in the physical examination and was subjected to surgery, in which intestinal ischaemia was found due to a disseminated peritoneal cystic disease, which had led to mesentery retraction. An intestinal resection with an end-ileostomy was performed. The results of the biopsy of the cystic lesions was disseminated peritoneal echinococcosis. Medical treatment was started with albendazole and praziquantel. CONCLUSION: This case shows a rare presentation of disseminated peritoneal hydatidosis, which led to intestinal ischaemia.
Assuntos
Equinococose/complicações , Intestinos/irrigação sanguínea , Isquemia/etiologia , Doenças Peritoneais/complicações , Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Terapia Combinada , Equinococose/diagnóstico , Equinococose/tratamento farmacológico , Equinococose/cirurgia , Humanos , Intestinos/diagnóstico por imagem , Intestinos/cirurgia , Isquemia/diagnóstico por imagem , Isquemia/cirurgia , Jejunostomia , Masculino , Isquemia Mesentérica/diagnóstico por imagem , Isquemia Mesentérica/etiologia , Isquemia Mesentérica/cirurgia , Pessoa de Meia-Idade , Doenças Peritoneais/diagnóstico , Doenças Peritoneais/parasitologia , Doenças Peritoneais/cirurgia , Praziquantel/uso terapêutico , Ruptura Espontânea , Tomografia Computadorizada por Raios XRESUMO
La hidatidosis es una parasitosis cuyo agente etiológico es el céstodo del género Echinococcus, siendo las especies más frecuentemente involucradas la E. granulosus y E. multilocularis. Puede afectar a cualquier órgano, aunque con mayor frecuencia se asocia a compromiso hepático y pulmonar. Los hallazgos imagenológicos clásicos en órganos habitualmente comprometidos están ampliamente descritos, no así en localizaciones poco comunes. Presentamos un caso de hidatidosis multiorgánica con compromiso peritoneal y pericárdico, estudiado con ultrasonido y tomografía computada, con revisión de la literatura actualmente disponible al respecto.
Abstract. Hydatidosis is a parasitic disease whose etiologic agent is the tapeworm of the genus Echinococ-cus, the species most frequently involved being E. granulosus and E. multilocularis. It can affect any organ, but most often is associated with liver and lung involvement. The classic imaging findings in organs that are usually involved are fully described, but not so for those in unusual locations. We report a case of multi-organ hydatidosis with peritoneal and pericardial commitment, studied with ultrasound and computed tomography, with a review of the currently available literature regarding this.