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      A rare case: Spontaneous gastric fistula from a hydatid cyst of the liver

      case-report

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          Abstract

          The hydatid cyst is a worldwide anthropozoonosis, which constitutes a health issue in Northern Africa. It may involve any organ, but it mostly affects the liver. This often asymptomatic disease can lead to multiple complications. Among them, spontaneous fistulization of a hepatic hydatid cyst in the stomach is exceptional even in endemic countries. We report the case of a 38-year-old female with febrile biliary colics due to a hydatid cyst of the liver fistulized in the stomach. The diagnosis was established based upon different clinical, biological and mainly radiological features. She received surgical treatment with satisfactory postoperative outcome.

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          Most cited references13

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          Echinococcosis: Advances in the 21st Century

          SUMMARY Echinococcosis is a zoonosis caused by cestodes of the genus Echinococcus (family Taeniidae). This serious and near-cosmopolitan disease continues to be a significant public health issue, with western China being the area of highest endemicity for both the cystic (CE) and alveolar (AE) forms of echinococcosis. Considerable advances have been made in the 21st century on the genetics, genomics, and molecular epidemiology of the causative parasites, on diagnostic tools, and on treatment techniques and control strategies, including the development and deployment of vaccines. In terms of surgery, new procedures have superseded traditional techniques, and total cystectomy in CE, ex vivo resection with autotransplantation in AE, and percutaneous and perendoscopic procedures in both diseases have improved treatment efficacy and the quality of life of patients. In this review, we summarize recent progress on the biology, epidemiology, diagnosis, management, control, and prevention of CE and AE. Currently there is no alternative drug to albendazole to treat echinococcosis, and new compounds are required urgently. Recently acquired genomic and proteomic information can provide a platform for improving diagnosis and for finding new drug and vaccine targets, with direct impact in the future on the control of echinococcosis, which continues to be a global challenge.
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            Ultrasound examination of the hydatic liver.

            Hydatic cysts of the liver were detected by ultrasound in 121 cases; all cases were confirmed surgically. Scans were classified based on sonographic analysis of the morphology and structure of the cyst. Five categories were found, which are thought to correspond to evolutionary stages of the hydatic cyst.
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              Guidelines for treatment of cystic and alveolar echinococcosis in humans. WHO Informal Working Group on Echinococcosis.

              WHO (1995)
              Summarized in this article are recent experiences in the treatment of human cystic echinococcosis (CE) and alveolar echinococcosis (AE) of the liver caused by the metacestode stages of Echinococcus granulosus and E. multilocularis, respectively. For CE, surgery remains the first choice for treatment with the potential to remove totally the parasite and completely cure the patient. However, chemotherapy with benzimidazole compounds (albendazole or mebendazole) and the recently developed PAIR procedure (puncture-aspiration-injection-re-aspiration) with concomitant chemotherapy offer further options for treatment of CE cases. Chemotherapy is not yet satisfactory: cure can be expected in about 30% of patients and improvement in 30-50%, after 12 months' follow-up. AE is generally a severe disease, with over 90% mortality in untreated patients. Radical surgery is recommended in all operable cases but has to be followed by chemotherapy for at least 2 years. Inoperable cases and patients who have undergone nonradical resection or liver transplantation require continuous chemotherapy for many years. Long-term chemotherapy may significantly prolong survival, even for inoperable patients with severe AE. Liver transplantation may be indicated as a life-saving measure for patients with severe liver dysfunction, but is associated with a relatively high risk of proliferation of intraoperatively undetected parasite remnants. Details of indications, contraindications, treatment schedules and other aspects are discussed.
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                Author and article information

                Contributors
                Journal
                BJR Case Rep
                British Institute of Radiology
                bjrcr
                BJR | Case Reports
                The British Institute of Radiology.
                2055-7159
                March 2022
                9 March 2022
                : 7
                : 6
                : 20210087
                Affiliations
                [1 ]org-divisionDepartment of Central Radiology, University Hospital Center IBN SINA, Mohamed V University, Faculty of Medicine , Rabat, Morocco
                [2 ]org-divisionDepartment of Visceral Surgery: Surgery A, University Hospital Center IBN SINA. Mohamed V University, Faculty ofMedicine , Rabat, Morocco
                Author notes
                Address correspondence to: Dr Behyamet Onka. E-mail: behyametonka@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-6204-7977
                Article
                BJRCR-D-21-00087
                10.1259/bjrcr.20210087
                8906147
                35300235
                d369a995-5a28-43fe-91ef-18bb1bbf7359
                © 2021 The Authors. Published by the British Institute of Radiology

                This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

                History
                : 26 April 2021
                : 06 July 2021
                : 07 July 2021
                Page count
                Figures: 6, Tables: 0, Equations: 0, References: 13, Pages: 4, Words: 2242
                Categories
                Case Report
                bjrcr, BJRCR
                oth, Emergency radiology
                gas-abd, Gastrointestinal and abdominal

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