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EDITOR’S QUIZ: GI SNAPSHOT

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From question on page 813

Helical computed tomography scan revealed a low density, well circumscribed cystic mass, 21×12×22 cm in size, in the left hepatic lobe with multiple daughter cysts floating inside, compatible with a hydatid cyst. The biliary system and spleen were normal (fig 1). Results of serum IgG antibody titre to Echinococcus granulosus was higher than 1:2560. Likewise, a pretreatment magnetic resonance cholangiogram was performed ruling out bile leaks.

In this case, perioperative treatment with albendazole, simple endocystectomy, aspiration of the residual contents of the cyst cavity, and omentoplasty were performed. After two months the patient was asymptomatic.

Cystic hydatic disease due to infection with the metacestode of Echinococcus granulosus has a worldwide distribution, and the liver is the most common site (70%). Surgery is the recommended treatment for hepatic hydatid cysts. However, encouraging reports suggest that under carefully controlled conditions, percutaneous aspiration with the use of concomitant antihelminthic therapy may be a safe alternative treatment.

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