The role of computerised tomography (CT) in the preoperative diagnosis<br /> and surgical treatment of intrabiliary rupture of hydatid cyst of the liver
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2009, Vol 26, Issue 1
Abstract
This is a retrospective study to evaluate the role of computerised tomography (CT) in the preoperative diagnosis of echinococcal cyst rupture into the biliary tract and the surgical management of this complication. Eight patients were studied, who were admitted to the outpatient department with clinical symptoms, followed by laboratory confirmation of cholangitis. Abdominal CT was performed in all patients, who were then operated upon, and the intraoperative findings confirmed the preoperative CT diagnosis. Partial cystectomy, cholecystectomy, intraoperative cholangiography, common bile duct exploration and insertion of T-tube drainage were performed in all patients Seven patients had rupture of the hydatid cyst into the intrahepatic bile ducts, one of whom had a simultaneous rupture into the subcapsular hepatic space. The other patient presented with rupture of the hydatid cyst into the gallbladder. In conclusion, the ideal treatment for intrabiliary rupture of hydatid hepatic cyst should conclude with exploration of the common bile duct, using intraoperative cholangiography. If the biliary tract is cleared of all cystic content, t-tube drainage should be sufficient. CT presents a valuable imaging method for quick and accurate diagnosis of intrahepatic biliary tract and gallbladder echinococcal cyst rupture. It contributes in a highly effective manner to the preoperative evaluation and optimally timed operative treatment of these patients.
Authors and Affiliations
P. ANTONOPOULOS, K. ALEXIOU, G. HARALAMBOPOULOS, F. KONSTANTINIDIS, A. FOTOPOULOS, E. KONSTANTINIDOU
Τα προβλήματα της ακούσιας ψυχιατρικής εξέτασης.<br /> Δύο ιστορικές βινιέτες: Δημόκριτος και Μακρυγιάννης
Η ακούσια ψυχιατρική εξέταση θέτει σημαντικά ηθικά και δεοντολογικά ζητήματα, καθώς στη σχέση ιατρού-ασθενούς παρεμβάλλεται ένας τρίτος, συνήθως οι δημόσιες αρχές που παρήγγειλαν την εξέταση. Τόσο η (αμφισβητούμενης ιστο...
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