Difficult diagnostics and serious biliary complications of liver echinococcosis

Česká verzia

Authors: R. Rosoľanka ¹ ; K. Šimeková ¹; Ľ. Laca ²; M. Szilágyiová ¹; D. Antolová ³
Authors place of work: Klinika infektológie a cestovnej medicíny JLF UK a UN Martin, Slovenská republika ¹; Chirurgická klinika JLF UK a UN Martin, Slovenská republika ²; Parazitologický ústav, Slovenská akadémia vied, Košice, Slovenská republika ³
Published in the journal: Gastroent Hepatol 2017; 71(3): 241-244
Category: Hepatologie: kazuistika
doi: https://doi.org/10.14735/amgh2017241

Summary

Echinococcosis is a dangerous parasitic disease that primarily attacks the liver. Several types of echinococci can be distinguished, among which Echinococcus multilocularis causes the alveolar form and is the most dangerous. Other important species of echinococcus include Echinococcus granulosus, which induces the cystic form of echinococcosis, and Echinococcus vogeli and Echinococcus oligarthus, which cause human polycystic echinococcosis. Inoperable or only partially surgically remediable forms of alveolar echinococcosis can occur with complications such as pressure on surrounding structures with eventual overgrowth of parasitic masses into neighboring tissues. Tissue infiltration and dissemination are typical findings in cases of alveococcosis, which can confuse doctors because the etiology is sometimes suggestive of malignant disease. Biliary complications occur in one third of cases and sometimes lead to cholestatic jaundice. Establishing a diagnosis of alveolar echinococcosis is not simple. Four examinations are used in combination: imaging techniques, serological testing, biopsy evaluation, and PCR (polymerase chain reaction). It is helpful to know the epidemiological history of the patient and to possess knowledge of parasite endemicity in different areas. The Slovak Republic, especially its northern regions, is currently considered an endemic area of occurrence. The authors present a case of a patient who, after initial discrepancies in diagnosis, developed complications including biliary oppression with a residual parasitic mass.

Key words:
alveolar echinococcosis – Echinococcus multilocularis – differential diagnosis

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
5. 2. 2017

Accepted:
31. 3. 2017

Zdroje

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