Echinococcosis is a helminthiasis from the cestodosis class, as a result of which an echinococcal cyst occurs in the lungs, kidneys, liver and other organs or tissues. Liver echinococcosis is caused by the introduction and maturation of tapeworm larvae in it.
Causes of disease
The determining factor in human infection with echinococcosis is his contact with a dog (carrier of parasites), which can get the disease by eating meat waste. Another potential culprit for dog infection may be the results of hunting - affected organs or carrion of wild animals.
In people, infection mainly comes from unwashed hands. Infection from a dog can occur through its coat or tongue. Other animals can similarly be spontaneous egg carriers and also acquire them from contact with a sick dog.
It is also possible that a person can acquire echinococcosis by eating fruits, vegetables and wild berries that have not been washed or have not gone through the initial processing. Water from natural lakes also serves as a source of infection.
Echinococcal cyst maystill appear among people working in sheep-breeding areas. Shepherds, shepherds and those who are in contact with these people (members of their family) were shearing sheep.
Signs of echinococcosis
Indicators of this disease are pain in the right hypochondrium, swelling of the liver, nausea. It takes several years, sometimes even decades, from the onset of infection to the discovery of the first symptoms. Manifestations of echinococcosis are determined by the location, volume, rate of growth of the cyst and its effect on nearby organs and tissues.
In some cases, the ailment may pass without any signs, and it can be accidentally detected during an ultrasound or x-ray. The disease often begins with the usual symptoms - a long subfebrile temperature, weight loss, general weakness, allergic reactions.
For the most part, an echinococcal cyst is initially located in the liver. The properties of blood circulation are a factor: the outflow of blood from the intestine goes to the portal vein, the blood is cleaned by the liver. Echinococcus entering the body is called liver echinococcosis.
Indicators of liver echinococcosis are:
- difficulty breathing as a result of localized diaphragmatic mobility;
- pain in the right side;
- nausea and vomiting;
- spontaneous jaundice (when squeezing bile ducts);
- enlarged liver.
How is an echinococcal liver cyst removed?
Treatment on their own suchdisease, like liver echinococcosis, is simply impossible. Although in very rare cases, self-healing occurs, associated with the death of the larvae. If a cyst originated by echinococcus is found, then there is no drug therapy that would eliminate the parasite. A ruptured cyst indicates the need for immediate surgery.
The entire cyst is removed through surgery. If it is located in a layer of liver tissue, then it is impossible to completely remove it due to the possibility of damage to the organ. In this situation, the chitinous wall of the cyst is removed and its contents are drawn out. Then the cyst itself is removed, since there is no possibility of its rupture and separation of the parasite. Upon successful removal of the cyst, the area of its binding is disinfected and sutured.
An operation on the liver is performed to completely remove the cyst with its membrane and contents, so that there is nothing in the organ itself, the abdominal and chest cavities. With a deep location or a serious lesion, the shell remains. The operation and its volume of work are determined by the size of the cyst and the problems that it caused. If the marginal placement of the cyst is detected, then it is removed along with the capsule. In such a surgical intervention, laser removal of an echinococcal cyst can be used.
Types of transactions
If there is multiple echinococcosis of the liver, large cysts, then it is resected. If one huge cyst is detected, an operation according to Spasokukotsky or Bobrov is performed, in which internal echinococcectomy takes place.
In order not to encounter infection of the cyst, the shell is not removed, butthe cavity is treated with drugs from parasites, for example, formalin, iodine or alcohol.
If the cyst is located under the diaphragm, and as a result of surgery a huge cavity appears, then it is tightened using the Pulatov or Delbe method or covering the formed cavity with a piece of the diaphragm.
If a cyst ruptures into the bile ducts, an emergency operation is performed. Remove the walls and cysts from the affected areas of the biliary tract. In such a situation, bile duct drainage is inevitable.
If a cyst ruptures into the abdominal cavity, then urgent surgery is done. During this process, cysts and capsules that have ended up in the bronchi, abdominal cavity and pleural region are removed. Semi-closed and closed echinococcectomy is performed. In severe situations, open echinococcectomy is performed.
With massive liver echinococcus, it is important to perform surgical intervention before problems arise. Liver surgery can be performed in 2-3 processes with an interval of two weeks to three months.
Mortality from echinococcus is from 1 to 5% of infected people. Relapses may also occur if the cyst has ruptured.
Prevention
Infection of pets and humans is based on procedures performed by medical and veterinary services. Domestic and service dogs should be constantly examined for helminths, especially in unfavorable areas, their therapy, euthanasia of homeless animals, as well asmeat control in slaughterhouses.
What do you need?
Regularly carry out hygiene for the population (dog breeders, livestock breeders, hunters and members of their families), keep dogs clean, constantly wash hands after communicating with them, as well as before meals, prohibit children from contact with homeless animals, how to wash vegetables, berries, drink only disinfected water.
Echinococcal cyst of the lung
The disease in the early stages is little manifested and is detected by x-ray examination of the lungs in the form of an oval silhouette with precise lines. The hemogram indicates eosinophilia.
In the formed degree of an unaggravated cyst, there is a constant and severe cough, shortness of breath, easier breathing at the site of the parasite, pain of various directions in the chest, movement of the mediastinal organs, and a reduction in percussion sound. X-ray shows in the lungs a huge round shadow with certain contours, which changes shape during respiratory excursions of the diaphragm.
The third stage of echinococcosis of the lung has a serious severity of pathological development and the process of complications. Symptoms of compression of large vessels and mediastinal organs are observed, deformation of the chest is noted, shortness of breath and hemoptysis appear. With the death of echinococci, inflammation of the cyst occurs with special clinical symptoms of empyema of the pleura or lung.
The opening of the cyst into the bronchus passage is accompanied by the discharge of a considerable amount of bright discharge with daughter bubbles of echinococcistreaked with blood. With suppuration of the opened cyst, purulent-hemorrhagic sputum comes out, and manifestations of poisoning are also observed. Disclosure of the cyst in the cavity of the shell provokes the appearance of exudative pleurisy and anaphylactic shock. X-ray examination shows a cavity with a horizontal surface of the liquid, not much manifested perifocal infiltration. Such infiltration is found if echinococcal cysts suppurate.
Treatment
They use surgical methods of therapy (the cyst is removed from the cuticular capsule, the lung is removed). The prognosis is quite serious, with a bilateral course and secondary echinococcosis - sad.
Echinococcosis kidney
Echinococcal cyst of the kidney today is rare, mainly in agricultural areas. The ailment is caused by the helminth Taenia echinococcus. Distributors of the causative agent of the disease are pets - dogs and cats. As a rule, one kidney is affected, in rare cases - two. Echinococcosis of the liver affects the population of the age group from 20 to 40 years, especially women.
The helminth egg enters the kidney in a lymphogenous or hematogenous way, most often in the cortical thickness.
Therapy and Prognosis
Treatment is mostly organ-preserving and operational. The most reliable and effective operation is an internal single-stage echinococotomy. A nephrectomy is also done.
Preventionechinococcosis requires he alth education procedures to educate people about the threat of infection from domestic animals, executive veterinary surveillance of slaughterhouses.
After surgical therapy, the prognosis is positive.
Echinococcosis of the spleen
Parasitic cysts of the spleen are often generated by echinococci. The duration of the malaise can last 15 years or more. According to the degree of development of the parasite, the surrounding organs of the abdominal cavity are pushed away, and the tissue of the spleen is necrotized.
This disease is not easy to detect. Echinococcal cyst of the spleen is accompanied by heaviness in the left hypochondrium, disorders or constipation, slight dull pains, nausea after eating, allergic reactions. Palpation reveals an enlarged spleen. Large blisters can burst, often resulting in death from the accompanying organ rupture.
With an active parasite, signs of allergy are often noted - hives, pruritus and others. With a complication of echinococcosis of the spleen, a rupture of the cyst or its suppuration with clinical manifestations of the disease may occur.
Stool analysis, unfortunately, does not reveal the presence of parasites. Diagnosis is based on X-ray and ultrasound, which show multi-chamber blisters.
Treatment
The most effective way to treat spleen cysts is laparoscopic surgery. Echinococcal cyst can be operated on in several ways:
- complete removal of the spleen;
- opening the cyst and extractingfrom its contents, cleansing the cavity;
- cutting out the affected area of the spleen;
- removal of a spleen cyst with its wall and contents;
- cutting out the cyst membrane.
Laparoscopic surgery for a spleen cyst is a common method of therapy that makes it possible to completely remove the source of the disease. Removal of a spleen cyst is performed using ultra-precise instruments and the introduction of a special camera. Duration of operational action - 1, 5-2 hours. Then, for some period, pain remains, but in a short period of time the patient is completely on the mend.
