case prensentation hydatid cyst.pptx
- 1. DR Zaira Hussain FCPS II RESIDENT
- 2. Fever -1 month Abdominal pain - 20 days.
- 4. PAST HISTORY: Multiple visits to nearby clinics due to same complaints. BIRTH HISTORY: Unremarkable. NUTRIONAL HISTORY: Consumes 3 meals a day,approximately 1300- 1500kcal/day. VACCINATION HISTORY: vaccinated according to EPI Schedule. DEVELOPMENTAL HISTORY: School going child with good academic score. FAMILY HISTORY: 3rd product of consanguineous marriage,all sibling are normal and alive PERSONAL: Decreased appetite with good sleep and normal bowel habits. SOCIOECONOMICS: Living in rented house Using boring water, Father is shopkeeper,no any pet history.
- 5. Active alert male child sitting on bed with,canula on left hand with following vitals: -HR= 90bpm -RR= 32bpm -TEMPERATURE= Afebrile -BP= 90/60(50th centile) A- C- CY-D- L- J- E-
- 6. WEIGHT= 30KG(-2.00Sds) HEIGHT=140cm(-2.02Sds)
- 7. INSPECTION: There are no scar mark, striae, visible veins or pulsation. PALPATION: Soft non tender on superficial palpation ,but on deep palpation mild tenderness in right upper quadrant. Liver was palpable 2cmbelow right costal margin, left lobe not palpable,soft in consistency with clear margins, total liver span 12cm. A well circumscribed mass palpable in epigastrium with smooth surface, regular margins and hard consistency measuring 2*2cm PERCUSSION: Fluid thrill and shifting dullness ve AUSCULTATION: Gut sounds audible.
- 8. INSPECTION: No precordial buldge,pulsation or scar mark. PALPATION: Apex beat palpated at 5ICS medial to mid clavicular line. AUSCULTATION: S1+S2+No added sound INSPECTION:Bilateral equal chest movement with respiration,no deformity seen PALPATION:Trachea centrally placed,chest expansion normal PERCUSSION:Normal AUSCULTATION:Bilateral equal air entry with normal vesicular breathing.
- 9. Unremarkable
- 10. ENTERIC WITH COMPLICATION LIVER ABSCESS HYDATID CYST LYMPHOMA/LEUKEMIA
- 16. SLIGHT HEPATOMEGALY WITH MILD PARENCHYMAL CHANGES. MULTIPLE CYSTIC MASSES IN THE LIVER AND SPLEEN. NORMAL GALL BLADDER,PANCREAS AND BOTH KIDNEYS. MULTIPLE CYSTIC MASSES PRESENT IN THE LOWER ABDOMEN AND LEFT LUMBAR REGION
- 20. MultIple cystic areas of varying sizes noted, involving liver and spleen and also with in peritoneum,showing internal septations,some of them showing peripheral daughter cysts. One of the splenic cyst measuring upto 8.0*6.6cm and the hepatic cyst is in segment VI which is measuring upto 4.9*4.1cm. One of the peritoneal cyst measuring 4.8*3.7cm. Lumbar muscular spasm noted. IMPRESSION:Findings represents diffuse multiple hydatid cyst involving liver,spleen and peritoneum.correlate with echinococcal titer
- 23. Treat medically for 3 months than follow patient in surgical OPD.
- 24. Admitted in UNIT-1 Maintained IV Line Off oxygen/orally allowed Injection 0.9% D/w started. Risek sachet 20mg (1*OD half an hour before breakfast) Tab Albendazole 15mg/kg divided 12 hourly, with meal.
- 25. Tab Albendazole 15mg/kg divided 12 hourly for three weeks with gap of one week. for nine consective weeks with gap of one week after each three week duration. Follow up in surgery OPD after three months.
- 27. the hydatic disease, caused by the larvae of Echinococcus granulosus, is a zoonotic disease potentially lethal, which can be found anywhere in the world, but especially in endemic areas. The hydatic cyst is mainly found in the liver (75% of the cases), being asymptomatic in most cases and discovered accidentally on a routine abdominal ultrasound or an ultrasound performed for diagnosing other pathologies.
- 34. Routine blood investigation are non specific-25% (Esinophilia abd raised bilirubin) Indirect hemagglutination tesr and ELISA are the most widely used methods for detection of anti-Echinococcus IgG antibodies
- 35. Chest Xray Ultraound abdomen CT-Scan MRI
- 41. MEDICAL; For cystic echinococcosis(CE) type 1 or 3a that are <5cm in diameter,albendazole chemostherapy alone(15mg/kg/day) orally divided twicw daily for 1-6 months maximamum 800mg/day may result in high rate of cure.
- 44. Factors predictive of success with chemotherapy are age of cyst(>2years),low internal complexity of the cyst,and small size and site of the cyst is not important,although cyst in bone respond poorly.for alveolar hydatidosis,if surgical removal is unsuccessful,the average mortality is 92% by 10 years after diagnosis.
- 45. Important measures ti interrupt transmission include aa,through handwashi,avoiding contact with dogs in endemic areas,boiling orr filtering water when camping,and proper disposal of animal carcasses. Other useful measures are control or treatment of feral dog population and regular praziquantel treatment of pets and working dogs in endemic areas. Vaccibes have been developed to prevent infection in grazing animals but are not widely used.