كيست هيداتيد شكمي با تظاهر كيست تخمدان در سونوگرافي: گزارش موردي

Abdominal hydatid cyst with presentation of ovarian cyst in ultrasonography: case report

زمينه: كيست هيداتيد يك بيماري آندميك در ايران و بسياري از كشورهاي خاورميانه مي‌باشد. هدف از اين مطالعه گزارش يك مورد تظاهر نادر كيست هيداتيد امنتوم بود. معرفي بيمار: زن 26 ساله با درد شكمي در ناحيه هيپوگاستر به درمانگاه زنان بيمارستان قائم در سال 1396 مراجعه كرد. در سونوگرافي تصوير كيست به سايز mm 95×105 در آدنكس راست رويت شد. به‌علت ادامه درد شكمي، بيمار لاپاراتومي شد. يك كيست cm 15×10 با جدار نازك چسبيده به امنتوم و انتهاي كوچك معده رويت شد كه با يك پديكول cm 6×3 به انحناي كوچك معده متصل بود. با گرفتن پايه پديكول، كيست به‌صورت كامل و بدون پارگي خارج گرديد. بافت خارج‌شده براساس گزارش پاتولوژي كيست هيداتيد چسبيده به امنتوم بود. نتيجه‌گيري: در صورت وجود توده سيستيك در فضاي پريتوان بايد كيست هيداتيد را در نظر داشت. جهت پيشگيري از عوارض و عود بيماري بهتر است در حين جراحي تا حد امكان از پاره شدن كيست اجتناب گردد.

Background: Hydatid cyst is an endemic disease in Iran and many middle eastern countries. The clinical presentation of Echinococcus granulosus infection depends upon the site of the cysts and their size. Small and/or calcified cysts may remain asymptomatic indefinitely. However, symptoms due to mass effect within organs, obstruction of blood or lymphatic flow, or complications such as rupture or secondary bacterial infections can result. The most common involved organs with this parasite are the liver and lung. Unusual areas of the disease include breast, adrenal, appendix, peritoneum, omentum and mesenteric. The purpose of this study was to report a rare case of abdominal hydatid cyst with presentation of ovarian cyst in ultrasonography. Case Presentation: A 26-year-old virgin woman with abdominal pain in the hypogastric region and lower and right quadrant of the abdomen, with gastric fullness and without nausea and vomiting referred to an emergent unit of Ghaem Hospital (an academic hospital of Mashhad University of Medical Sciences) in June 2017. In an ultrasound, a cyst of 95×105 mm in right adnexa of uterus was seen. Due to continued abdominal pain, laparotomy was performed for the patient. At the time of laparotomy, the ovaries, uterus and adnexa were completely normal. A 10×15 cm cyst was seen with a thin wall which adhering to the omentum and the small end of the stomach. Frozen section biopsy reported hydatid cyst. Conclusion: Considering that hydatid cyst is endemic in Iran, the presence of cystic mass in the peritoneal cavity, hydatid cyst should be considered. To prevent complications and relapse, it is best to avoid cyst rupture during surgery as much as possible.