Advices for Life


November 19, 2016 00:15

hydatid cyst

cyst - a parasitic disease caused by the larval stage Ehinocococcus granulesus with lesions of the liver, lungs and other organs with a fine capillary network.Man is the intermediate host of the tape helminth, they can also be: horses, camels, pigs, cows.Definitive hosts are dogs, wolves, cats, foxes and other predators.In the intestine, the definitive hosts of the parasite matures sexually mature: 4-7 cm long worm that attaches to the intestinal wall with the help of scolex four muscular suckers and proboscis with hooks forty.To fasten the head 3 segments with different phases of development: young proglottids androgynous proglottids, mature proglottids.Mature proglottids as maturation, is rejected and intestinal masses and shatters the environment 400-800 eggs.Inside each egg has shestikryuchny embryo - hexacanth.

How is the cyst?

Human infection occurs by stroking the hair of animals: dogs, cats, cows, horses - or blades biting infected eggs.Therefore, the disease is more prevalent in areas with w

ell-developed animal husbandry or extensive forests, but it can occur in any area, as eggs can be spread with dust.They are very viable: at 0 ° live 116 days, and at zero temperature up to 6-8 months.

Even boiling withstand up to 20 minutes.This is despite the fact that a dog can provide up to 20 thousand parasites.Multiply this figure by 800, and you will clearly see the contamination of the environment.Therefore endemic areas can be formed.Eggs

parasite from entering the stomach environment, penetrate into the portal venous network and get stuck in the capillaries of the liver, smaller deposited in the pulmonary capillaries.These are the two most frequent localization.But if the patient due to pulmonary hypertension, pulmonary arteriovenous shunts open, eggs can enter the systemic circulation with a lesion of any organ and tissue, often the kidneys, spleen, and brain.Develops slowly, only 5-6 months after infection, the larva is formed.

In the liver of hexacanth formed cyst - larvotsista from 1 to 50 cm, but there are cases larvotsist up to 10 liters.It is filled with murky liquid inside floating bubbles child, they may be grandchild bubbles - hydatid sand.The lung volumes and smaller bubbles contain hydatid sand so they are called "atsefalokistami".Around lavrotsisty a dense fibrous capsule.

parasite is very complex pathogenesis of the disease, but in full it is not necessary for clinicians.It is necessary to remember the highlights: allergenoaktivna cyst forms poliallergiyu, eosinophilia and a set of specific antibodies, which allow immunoreaction identify the disease in its initial stage.Hydatid cyst causing compression of the tissue atrophic with full or partial dysfunction, which can be detected by laboratory tests 4.Gap, opening it with a hit on the contents of the peritoneum causes a deep, immediate action anaphylactic shock, which is practically impossible to suppress.Immunity is not formed.Possible re-infection.But unless cyst acts as a monopolist.Other bubbles when it is extremely rare, unlike alveococcosis.Clinic polymorphic.During the release stage 3;

  1. latent (asymptomatic) - from the moment of penetration hexacanth before the first symptoms.No complaints.Cyst detected incidentally during abdominal surgery.Less often, and in a later period, when the cyst reaches 3-5 mm can be detected by ultrasound or CT scan.
  2. Symptomatic when symptoms violation organ localization function are due to compression of the most parenchymal organ and surrounding tissues.Common symptoms include weight loss, weakness, urticaria, zozinofilliya blood.Local manifestations are expressed very weakly.With the localization of the liver pain, feeling of heaviness in the right upper quadrant, at an external localization palpable tumor flexible education, reveals a symptom shake gidatid (on tumor formation set palm with fingers spread apart, the characteristic tremor is detected with strong tapping on the third finger).If the cyst is localized in the lung: chest pain;stubborn dry cough, hemoptysis.
  3. complications: cyst abscesses, calcification, break into the peritoneal or pleural cavity.It is accompanied by pain syndrome, anaphylactic shock, the formation of purulent fistulas, ascites, jaundice, liver failure, respiratory failure, atelectasis of the lungs and other.

duration of each stage can not be established, often asymptomatic, up to 5 years, imperceptibly 3-5 years.In most cases, it is revealed only with the development of complications.

True relapses observed rarely, long after radical surgery.False relapses caused by violation of radical left wall portions colonization subsidiaries bubbles marked one year after surgery in 11.8% of cases.

As recognized cyst?

Diagnosed cyst on the basis of epidemiological history, clinical presentation, data of complex clinical examination:. X-ray, ultrasound, functional and laboratory, magnetic resonance, etc. X-ray methods are most effective in calcification of the bladder, as this reveal the ring calcification, characteristiconly echinococcus.In lung cyst revealed fibrozirovannym ring calcification, its shape changes at different phases of breathing - a symptom Nemenova;between the bladder shell and the fibrous capsule often traceable gas bar - a symptom Velo Peten.If the cyst ruptures lung X-ray is generated symptom Harz-Sogersa - formed specific shade, having a form of "floating lily" or "floating ice floes," which are caused by the shadow of the bladder wall and shell shadow.

Due to possible contamination cyst should not be punctured.But if the puncture is made in error, make urgent laboratory, research (presence of chitin, scolex hooks) and immediately carried out;urgent surgery.With the puncture can be carried out and the reaction Katsoni: one forearm intradermally administered 0.1 ml of saline solution;to another - 0.1 ml of sterile puncture the bubble - there is a reaction in the form of redness, itching, swelling.The reliability of its up to 50%, so almost do not apply;

mainly use two specific reactions;

  1. immunological reactions latex agglutination Fishman.The reliability of its 96.3%.It is safe for the patient;It can be used in relapsed.Mainly used in the mass trials in endemic areas.
  2. Along with latex agglutination test is carried out and serological enzyme-immunological reactions with specific antigens.This response reveals the invasion already in 7-21 days after infection.With its help differentiate cyst and alveococcosis.

Alveococcosis - multilocular echinococcus caused by helminth: Ehinokokkus alveolaris.Build it and hydatid tapeworm infestation are similar.It is localized mainly in the liver.Final host: fox, arctic fox, wolf, dog, cat.Man - intermediate host.

Infection occurs: when skinning hides, tapping out their room, when in contact with contamination of animals by eating berries contamination.Mainly observed in taiga regions, most hunters, eggs are very hardy, even at minus 40 degrees to survive throughout the year.

observed the same three stages, as in the hydatid tapeworm in the development of the disease.The clinic is also expressed in the development of liver failure: weakness, weight loss, jaundice;but, unlike cirrhosis never ascites.The liver is initially enlarged and very dense - on Lyubimov - "Iron Liver" - later it becomes uneven to the touch.

Complications differ from hydatid echinococcosis: sprouting in the neighboring organs, metastasizes to the lungs, brain.Parasitic tumors susceptible to decay in the center of a sequestration can be a breakthrough in the abdominal and chest cavities, hepatic ducts and bronchi.

diagnosis in the early stages of development are rarely placed - 15% of cases, mainly in the mass screening of the population.Most often detected in the later period during the examination of the liver to determine the cause of liver failure;On plain film small foci of calcification - "lime spray".More reliable data are obtained by computed tomography and laparoscopy.