HYDATID CYST – A CHALLENGING DIAGNOSIS AND TREATMENT MATTER FOR THE YOUNG PRACTITIONER - THE MANAGEMENT OF A COMMON PATHOLOGY WITH FREQUENT COMPLICATIONS

Oana Andreea Dobrin1, Andreea Frasin1, Elena Stanciu 1, R. I. Toader1, D. N. Păduraru 1,2, Adriana Elena Nica 1,3, C. V. Toma 1,4, V. C. Coşei5

1The University of Medicine and Pharmacy „Carol Davila”, Bucharest, Romania
2III’rd Department of General Surgery, University Emergency Hospital Bucharest, Romania
3Department of Anaesthesiology, University Emergency Hospital Bucharest, Romania
4The Department of Urology, Clinical Hospital “Prof. Dr. Theordor Burghele” Bucharest, Romania
5The Institute of Pneumology “Marius Nasta” Bucharest, Romania

Corresponding author: Dan Nicolae Păduraru
Phone no. 0040744756443
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Abstract

The hydatid cyst, or echinococcosis, is a parasitic disease whose etiologic agent is Echinococcus granulosus, a parasite pertaining to the Cestodes class. Most commonly, in humans, the disease is transmitted digestively, through the eggs of tapeworms found on the animal fur. In echinococcosis, the existence of an occupational risk for animal breeders was identified, which explains farming Romania as a hyperendemic country. The complicated clinical picture of Echinococosis may possess hurdles for the young practitioner, in his endeavor to establish a correct diagnosis. This paper presents the particular case of a 49-year-old man, diagnosed with lung hydatid cyst, without evidence of liver injury, even though the normal life cycle of the parasite involves liver passage. At first glance, the patient arrived in a hospital department complaining of febrile symptoms with purulent cough and chest pain that does not resonate with the clinical picture of a hydatid cyst, as was later discovered from anamnesis. From the patient's medical record, it stems that the patient refused surgical interventions, and followed an antiparasitic treatment for a year.In the eyes of a young practitioner, all this information hampers the differential diagnosis, delaying the decision of addressing the patient’s problems through a surgery.In a general sense, depending on the organ that is affected, the most important part of the treatment of the hydatid cyst is represented by the surgical approach, which must be adapted to each case, taking into account the existing complications, the risks that may arise, the anatomic and pathologic substrate of the patient.The laparoscopic approach is preferable because of the aesthetic result, but in this case, a classical method was used, because of the high risk of complications during and after surgery.

Keywords: hydatic cyst, echinococcosis, Cestodes class, Echinococcus granulosus

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