背景:筋膜吸虫病是一种人畜共患,具有广泛的临床表现。然而,它可能经常被忽视,尤其是在急性期,因为不确定的症状。肝片吸虫的初始表现与恶性肝肿块或复杂肝囊肿相似。这里,我们报告一例肝片吸虫引起的肝肿块。
方法:一名48岁的女性主诉为上腹部和右侧软骨不适,伴有恶心和呕吐。超声检查(USG)显示肝脏VIII段有异慢性病变,几乎没有囊性病变。CECT腹部和骨盆给人的印象是肝脏右叶不明确的不规则低密度病变,周围和中央囊性区域逐渐增强,提示寄生虫性肝脏感染可能是肺泡棘球球菌。行右肝切除术,患者出院,无任何并发症。
结论:片状吸虫病在发达国家并不常见,但在发展中国家更为常见。确定粪便中的肝片吸虫卵是诊断肝片吸虫病的标准方法。从无症状感染到严重的肝硬化,可能会引起多种临床体征。肝脏复杂包虫囊肿的手术可能会受到严重并发症的困扰。手术治疗的技术选择仍然没有定论。
结论:肝片吸虫感染可以模拟恶性肝肿块或复杂的肝囊肿,因为其表现不确定。这种疾病可以通过公共教育和环境预防措施来预防。
BACKGROUND: Fascioliasis is a zoonotic infestation which presents with a wide spectrum of clinical pictures. However, it may often be overlooked, especially in the acute phase, because of uncertain symptoms. Fasciola hepatica can have an initial presentation similar to malignant liver mass or complex hepatic cyst. Here, we report a
case of a hepatic mass caused by fasciola hepatica.
METHODS: A 48-year-old woman came with chief complaints of epigastric and right hypochondrial discomfort associated with nausea and vomiting. Ultrasonography (USG) showed a heterochronic lesion in the segment VIII of the liver with few cystic lesions. CECT abdomen and pelvic gave impression of ill-defined irregular hypodense lesions in the right lobe of the liver with progressive enhancing peripheral and central cystic areas suggestive parasitic liver infestation likely echinococcus alveolaris. Right hepatectomy was done and the patient was discharged without any complications.
CONCLUSIONS: Fascioliasis is uncommon in developed countries but more commonly seen in developing countries. The identification of fasciola hepatica eggs in the stool is a standard method for the diagnosis of fascioliasis. Fascioliasis may cause a wide variety of clinical signs ranging from asymptomatic infection to severe liver cirrhosis. Surgery for complex hydatid cysts of the liver is potentially burdened by serious complications. Technique of choice for surgical management remains inconclusive.
CONCLUSIONS: Fasciola hepatica infection can mimic a malignant liver mass or a complex hepatic cyst because of its uncertain presentation. The disease can be prevented with public education and environmental precautions.