青海大学附属医院于2021年1月收治1例82岁男性“左腹壁下巨囊肿”患者,患者自述左上腹疼痛20余天,有40余年肝棘球蚴病史、牛羊等动物密切接触史和长期流行区生活史。入院后查体,左上腹可触及一大小约为10 cm × 5 cm的实性包块,质韧,边界清,压痛阳性。实验室检查,棘球绦虫IgG抗体阳性。结合腹腔三期动态增强CT、腹部MRI等相关影像学检查后诊断为“腹腔-皮下细粒棘球蚴病”,排除相关手术禁忌症后行腹腔细粒棘球蚴包囊内囊摘除术,术中探查发现病灶沿左侧第9~10前肋间突破腹壁向外生长至皮下,与腹腔棘球蚴包囊相通。术后第7天,患者好转出院。患者口服阿苯达唑15 mg/（kg·d）,早晚餐后分服,继续治疗6月。术后1月复诊,患者未诉特殊不适,行腹部、盆腔CT平扫后提示术后改变,余未见明显异常。

An 82-year-old male patient, who was diagnosed with the left inferior abdominal giant cyst, was admitted at the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University on January 28, 2021. The patient had the left upper abdominal pain for more than 20 days, and a history of more than 40 years of hepatic echinococcosis, history of close contact with cattle, sheep and other animals and history of living in endemic areas. A solid lump about 10 cm × 5 cm in size was reached in the upper left abdomen at admission examination, with tough texture, clear boundary and positive tenderness. Laboratory tests showed positive echinococcus IgG antibody. In combination with the abdominal phase Ⅲ dynamic enhanced CT, abdominal MRI and other related imaging examinations, a diagnosed of“celiac-subcutaneous echinococcosiswas” made. The excision of intraperitoneal echinococcus granulosus cyst was performed after completing relevant examinations. Intraoperative exploration revealed that the lesion broke through the abdominal wall along the left 9th to 10th anterior intercostal space and grew outward to the subcutaneous area, which was connected with the abdominal hydatid. On the 7th postoperative day, the patient was discharged. The patient was prescribed with albendazole 15 mg/(kg·d) orally, divided after breakfast and dinner, and continued with the treatment for 6 months. One month after the surgery, the patient was followed up at the clinic. No special discomfort was reported, and postoperative changes were indicated after plain CT scan of abdomen and pelvic cavity, and no obvious abnormalities were observed.