Perforated Hepatic Hydatid Cyst into the Peritoneum with Mild Symptoms

Rupture into the abdominal cavity is a rare but serious complication of hydatid disease that necessitates emergency surgical intervention. We present herein a case with mild abdominal symptoms due to hydatid cyst rupture into the peritoneum after trauma. A 24-year-old man was admitted to the emergency room with mild abdominal pain. His symptoms had started after a fall four days earlier. Ultrasonography and computed tomography showed cystic lesions in the liver and peritoneum with intraabdominal free fluid. He was treated surgically with partial cystectomy and falciformoplasty. Postoperative albendazole therapy was given for two months. There was not recurrence four months postoperatively at control computed tomography

Subcutaneous hydatid cysts occurring in the palm and the thigh: two case reports

<p>Abstract</p> <p>Introduction</p> <p>Hydatid cyst disease is common in some regions of the world and is usually located in the liver and lungs. This report presents two cases of primary hydatid cysts located subcutaneously: one in the medial thigh and one in the left palm between the index and middle fingers.</p> <p>Case presentations</p> <p>A 64-year-old male farmer visited our hospital because a swelling on the right medial thigh had grown during the last year. Superficial ultrasound and computed tomography revealed a lesion resembling a hydatid cyst. A germinative membrane was encountered during surgical excision. Pathological examination was compatible with a hydatid cyst. The second case involved a 67-year-old male farmer who complained of a swelling that had grown in his left palm in the last year. The preliminary diagnosis was a lipoma. However, a hydatid cyst was diagnosed during surgical excision and after the pathological examination. The patient did not have a history of hydatid cyst disease and hydatid cysts were not detected in other organs. There has been no disease recurrence after following both patients for 3 years.</p> <p>Conclusion</p> <p>A hydatid cyst should be considered in the differential diagnosis of subcutaneous cystic lesions in regions where hydatid cysts are endemic, and should be excised totally, with an intact wall, to avoid recurrence.</p

Giant hepatic hydatid cyst with sub-fascial extension treated by open minimally invasive surgery: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hepatic hydatid disease can be successfully treated by a variety of modalities.</p> <p>Case Presentation</p> <p>We report a case of a 60 year old male with giant hepatic hydatid disease who presented with a huge cystic mass in the upper abdomen. Diagnosis was confirmed by serology, ultrasonography and CT scan. The patient was treated successfully by open minimally invasive surgery with minimum breaching of the peritoneal cavity using a laparoscopic trocar to evacuate the cyst.</p> <p>Conclusion</p> <p>The use of a laparoscopic trocar through a small abdominal incision in selected patients with hepatic hydatid disease with subfascial extension can be a safe, minimally-invasive option of treatment</p

Factors influencing chloride deposition in a coastal hilly area and application to chloride deposition mapping

Chloride is commonly used as an environmental tracer for studying water flow and solute transport in the environment. It is especially useful for estimating groundwater recharge based on the commonly used chloride mass balance (CMB) method. Strong spatial variability in chloride deposition in coastal areas is one difficulty encountered in appropriately applying the method. A high-resolution bulk chloride deposition map in the coastal region is thus needed. The aim of this study is to construct a chloride deposition map in the Mount Lofty Ranges (MLR), a coastal hilly area of approximately 9000 km&lt;sup&gt;2&lt;/sup&gt; spatial extent in South Australia. We examined geographic (related to coastal distance), orographic, and atmospheric factors that may influence chloride deposition, using partial correlation and regression analyses. The results indicate that coastal distance, elevation, as well as terrain aspect and slope, appear to be significant factors controlling chloride deposition in the study area. Coastal distance accounts for 70% of spatial variability in bulk chloride deposition, with elevation, terrain aspect and slope an additional 15%. The results are incorporated into a de-trended residual kriging model (ASOADeK) to produce a 1 km×1 km resolution bulk chloride deposition and concentration maps. The average uncertainty of the deposition map is about 20–30% in the western MLR, and 40–50% in the eastern MLR. The maps will form a useful basis for examining catchment chloride balance for the CMB application in the study area

Predictive model of biliocystic communication in liver hydatid cysts using classification and regression tree analysis

<p>Abstract</p> <p>Background</p> <p>Incidence of liver hydatid cyst (LHC) rupture ranged 15%-40% of all cases and most of them concern the bile duct tree. Patients with biliocystic communication (BCC) had specific clinic and therapeutic aspect. The purpose of this study was to determine witch patients with LHC may develop BCC using classification and regression tree (CART) analysis</p> <p>Methods</p> <p>A retrospective study of 672 patients with liver hydatid cyst treated at the surgery department "A" at Ibn Sina University Hospital, Rabat Morocco. Four-teen risk factors for BCC occurrence were entered into CART analysis to build an algorithm that can predict at the best way the occurrence of BCC.</p> <p>Results</p> <p><b>I</b>ncidence of BCC was 24.5%. Subgroups with high risk were patients with jaundice and thick pericyst risk at 73.2% and patients with thick pericyst, with no jaundice 36.5 years and younger with no past history of LHC risk at 40.5%. Our developed CART model has sensitivity at 39.6%, specificity at 93.3%, positive predictive value at 65.6%, a negative predictive value at 82.6% and accuracy of good classification at 80.1%. Discriminating ability of the model was good 82%.</p> <p>Conclusion</p> <p>we developed a simple classification tool to identify LHC patients with high risk BCC during a routine clinic visit (only on clinical history and examination followed by an ultrasonography). Predictive factors were based on pericyst aspect, jaundice, age, past history of liver hydatidosis and morphological Gharbi cyst aspect. We think that this classification can be useful with efficacy to direct patients at appropriated medical struct's.</p

Modified capitonage in partial cystectomy performed for liver hydatid disease: Report of 2 cases

BACKGROUND: Several techniques have been described in liver hydatid disease surgery, with most well known partial cystectomy, capitonage and introflexion. METHODS: We present a technical modification on open partial cystectomy for liver hydatid disease. We performed this operation in 2 patients with liver echinococcosis. The cyst is being unroofed and evacuated from the daughter cysts. The identified bile vessels ligated. The remnants of the anterior wall (capsule of the cyst) are anchored with sutures in the posterior wall in a manner that the cavity of the cyst disappears. RESULTS: In both patients the disease eradicated. No postoperative complications were observed including bile leaking and/or abscess formation. CONCLUSIONS: Our technique helps in the fast, and effective mobilization of the patient, as well as in the minimization of postoperative bile leaking

Comparison of the application of low concentration and 80% phenol solution in pilonidal sinus disease

Objectives Many conservative methods have been applied in the treatment of pilonidal sinus disease (PSD). The most commonly used conservative treatment is 80% phenol solution. Our observations demonstrated that 80% phenol solution caused much destruction in the sacrococcygeal region. Design In this study low concentrations of phenol were used with the aim of reducing the unwanted side-effects of high-concentration phenol without reducing the therapeutic effects. Participants We treated 112 patients (18 women, 94 men) with PSD using phenol solution. Patients were divided into two groups: Group A was treated with a 40% solution of phenol solution, and Group B was treated with an 80% solution of phenol solution. Setting All patients were treated on an outpatient basis. One mL of low (40%) or high (80%) concentration phenol solution was injected into the main sinus orifice. During the check it was observed and noted whether there was skin necrosis, fatty tissue necrosis or abscesses. Main outcome measures The mean age was 27.4 years (6–44). The median length of symptoms was seven months (0.5–132). In the 2.8 years (1–6) of mean follow-up period, the disease recurred in 13 (11.6%) patients. Results This treatment procedure was well-tolerated by all the patients except for those who had unwanted results. No patients in group A had skin necrosis, and only one had abscesses. In group B two patients had abscesses, and three had skin necrosis. Fatty tissue necrosis was seen in one patient in Group A and in five patients in Group B. Recurrence rates were four (7.4%) cases in Group A and nine (15.5%) cases in Group B. Conclusions It is possible to treat patients in a shorter time with a considerably smaller loss of working time, since the destruction of peripilonidal adipose tissue and skin is less. Therefore, the use of low-concentration phenol solution is an option to be considered in the treatment of PSD.PubMe

Impact of system factors on the water saving efficiency of household grey water recycling

Copyright © 2010 Taylor & Francis. This is an Author's Accepted Manuscript of an article published in Desalination and Water Treatment Volume 24, Issue 1-3 (2010), available online at: http://www.tandfonline.com/10.5004/dwt.2010.1542A general concern when considering the implementation of domestic grey water recycling is to understand the impacts of system factors on water saving efficiency. Key factors include household occupancy, storage volumes, treatment capacity and operating mode. Earlier investigations of the impacts of these key factors were based on a one-tank system only. This paper presents the results of an investigation into the effect of these factors on the performance of a more realistic ‘two tank’ system with treatment using an object based household water cycle model. A Monte-Carlo simulation technique was adopted to generate domestic water appliance usage data which allows long-term prediction of the system's performance to be made. Model results reveal the constraints of treatment capacity, storage tank sizes and operating mode on percentage of potable water saved. A treatment capacity threshold has been discovered at which water saving efficiency is maximised for a given pair of grey and treated grey water tank. Results from the analysis suggest that the previous one-tank model significantly underestimates the tank volumes required for a given target water saving efficiency

ИНФЕКЦИОННЫЕ ОСЛОЖНЕНИЯ ПОСЛЕ ТРАНСПЛАНТАЦИИ ПЕЧЕНИ В ОТДЕЛЕНИИ РЕАНИМАЦИИ И ИНТЕНСИВНОЙ ТЕРАПИИ В УСЛОВИЯХ ОДНОГО ЦЕНТРА

Introduction. Despite the advances in antibiotherapy and critical care management, infectious complications remain among the leading complications after liver transplantation related with mortality and morbidity. This study analysis the incidence and pattern of infections and possible prognostic factors of infectious compli- cations retrospectively in a single center. Patients and Methods. Results of 30 consecutive patients with a primary liver transplantation history in a single center between August 2011 and August 2012 and a positive culture result in the first month in the ICU were analysed retrospectively. Results. During the first 1 month stay in the ICU postoperatively 30 (13,63%) patients had at least 1 infection. Total number of infections were 68. Mortality rate of the infected patients was 53,3% (n = 16). Among these infections, 25 (36,76%) of them were in deep surgical sites. Eighteen of the 30 patients (60%) were infected with a single microorganism. Eleven patients (36,66%) had a single infection episode. Microorganism were gram negative in 52 (76,47%) of the infections, gram positive in 14 (20,58%) of the infections, rest of the 2 (2,94%) infections were due to Candidiasis. Among the possible risk factors contributing to mortality, there was a statistically significant dif- ference (p &lt; 0,001) between the platelet counts of the mortality and surviving groups of the patients. Conclu- sion. Infections are among the preventable risk factors for mortality and morbidity after liver transplantation. Our data reveals a significant relation between trombocytopenia and mortality among the infected patients. Further studies focusing on this relation would expose the mechanisms and any possible contribution in cli- nical management of the patients. Цель исследования – провести ретроспективный анализ заболеваемости и характер инфекции, а также возможных прогностических факторов летальности в условиях одного центра. Материалы и методы исследования. Ретроспективно были изучены результаты лечения 220 пациентов с трансплантацией пе- чени в период между августом 2011 года и августом 2012-го. У 30 пациентов наблюдались инфекционные осложнения с положительными результатами посевов в первый месяц интенсивной терапии в условиях одного центра. Результаты исследования. В течение первого месяца пребывания в отделении интен- сивной терапии после операции 30 (13,63%) пациентов имели по крайней мере одну инфекцию. Об- щее число случаев инфекции было 68. Смертность среди инфицированных пациентов составила 53,3% (n = 16). Среди этих инфекций 25 (36,76%) были интраабдоминальными. Восемнадцать из 30 пациентов (60%) были инфицированы одним возбудителем. Одиннадцать пациентов (36,66%) имели один эпизод инфекции. Микроорганизмы были грамотрицательными в 52 (76,47%) случаях, грамположительными в 14 (20,58%) случаях, остальные 2 случая (2,94%) инфекций были обусловлены кандидозом. Среди воз- можных факторов риска, влияющих на смертность, была статистически достоверно выявлена (р &lt; 0,001) связь между количеством тромбоцитов и летальностью пациентов. Заключение. Инфекции являются одними из предотвратимых факторов риска смертности и заболеваемости после трансплантации печени. Наши данные свидетельствуют о значимой связи между тромбоцитопенией и смертностью среди инфи- цированных пациентов. Дальнейшие исследования, посвященные этому вопросу, внесут весомый вклад в клиническое ведение таких больных в будущем.