Abstract:

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.

Key words: Echinococcosis cysticus, Peritoneal metastasis, Breaking through the abdominal wall, Subcutaneous hydatid