CASE REPORT


Hydatid Recurrence Medically Treated by Albendazole



Imen Khammari1, 3, *, Mohamed Amine El Ghali2, Salsabil Nasri2, Imen Dhib1, Hamed Chouaieb1, Alia Yaacoub1, 3, Moncef Ben Said1, 3, Rached Letaief2, Akila Fathallah1, 3
1 Laboratory of Parasitology, Faculty of Medicine of Sousse, Mohamed Karoui street, 4002, Sousse, Tunisia
2 General and Digestive Surgery Department, Farhat Hached University Hospital, Ibn Jazzar Street, Sousse, 4000, Tunisia
3 Laboratory of Parasitology, Farhat Hached University Hospital, Ibn Jazzar Street, Sousse, 4000, Tunisia


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© 2018 khammariet al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Laboratory of Parasitology, Faculty of Medicine of Sousse, Mohamed Karoui street, 4002 Sousse, Tunisia. Laboratory of Parasitology, Farhat Hached University Hospital, Ibn Jazzar Street, Sousse 4000, Tunisia, Tel: +216 73 22 14, Fax: +216 73 22 67 02; E-mail: imenkhammari@yahoo.fr


Abstract

Introduction:

Hydatidosis or Cystic Echinococcosis (CE) is a highly endemic parasitosis in Tunisia. The combination of surgery with an adjuvant anti-hydatid medical treatment was shown to reduce the risk of relapses, recurrences and post-operative complications.

Case Report:

We report the case of a liver hydatid cyst recurrence in a woman hospitalized for acute cholangitis of hydatid origin. The patient had a resection of the protruding dome and a bipolar drainage of the main bile duct and cystic cavity with a postoperative biliary fistula and a collection of the residual cavity that required endoscopic sphincterotomy. The patient was then followed up every 6 months. Three years after the intervention, CT scan showed a hydatid recurrence of two new liver cysts. Surgery was expected to be difficult and risky. Medical treatment with albendazole was decided before surgery.

The CT scan performed after 9 months showed important regression of two hydatic cysts. Medical treatment has been extended. Two years later, CT scan was in favor of an involuted aspect of both cysts.

The treatment of CE is primarily surgical; medical treatment alone or associated with surgery can be a good alternative, especially in case of hydatid recurrence and when surgery is risky, mainly in stage I hydatic cyst.

Keywords: Cystic echinococcosis, Hydatidrecurrence, Albendazole, Surgery, Healing, Regression.