Liver echinococcosis: how to get infected, diagnosis and surgery in Tashkent

How does infection occur?

The adult parasite lives in the intestines of dogs and other canids. With their feces, eggs end up on the animal's fur, soil, grass, vegetables and water. A person becomes infected by swallowing eggs - from unwashed hands after contact with a dog, from poorly washed greens and vegetables, from unboiled water. From the intestine, the larvae enter the bloodstream and settle most often in the liver, less often in the lungs and other organs.

• Contact with dogs, especially guard and herding dogs
• Working with livestock, slaughtering animals, processing hides
• Eating unwashed vegetables, greens, berries
• Drinking raw water from open sources

How it manifests itself

While the cyst is small, there are no complaints. As it grows, heaviness and dull pain appear in the right hypochondrium, a feeling of fullness. With large cysts, the liver becomes enlarged and the bile duct may be compressed with the development of jaundice. Complications occur suddenly and require emergency care.

• Heaviness, discomfort and dull pain in the right hypochondrium
• Liver enlargement, sometimes palpable mass
• Nausea, loss of appetite, weakness
• Allergic manifestations - urticaria, skin itching
• Jaundice due to compression of the bile ducts

Survey

1. УЗИ печени — main и самый доступный метод; типичная киста имеет характерные ультразвуковые признаки, включая слоистую стенку и дочерние пузыри.
2. МСКТ или МРТ — уточняют размер, число и расположение кист, их отношение к сосудам и желчным протокам, что необходимо для планирования операции.
3. Серологические тесты крови на антитела к эхинококку — вспомогательный метод, может быть отрицательным при неактивной кисте.
4. Общий и биохимический анализ крови, печёночные ферменты, эозинофилия.
5. Рентген или МСКТ грудной клетки — исключение поражения лёгких.

Treatment

• Laparoscopic echinococcectomy - removal of the cyst through punctures; The category of surgery depends on the size, number and location of the cysts.
• Open surgery - for large, multiple, centrally located cysts and complications.
• Surgery for recurrent and complicated echinococcosis is a separate, technically more complex category of interventions.
• Antiparasitic therapy with albendazole - before and after surgery, in courses, to reduce the risk of relapse; As an independent method, it is used to a limited extent.
• Observation with repeated ultrasound - for small inactive calcified cysts according to the doctor's decision.

During the operation, the surgeon works according to the rules of antiparasitic safety: the field is isolated, the contents should not enter the abdominal cavity, otherwise secondary echinococcosis with multiple new cysts will develop.

Prevention

1. Мыть руки после контакта с собаками и до еды — самая действенная мера.
2. Регулярно дегельминтизировать домашних и сторожевых собак.
3. Не скармливать собакам сырые внутренние органы забитого скота.
4. Тщательно мыть овощи, зелень и ягоды, особенно of огорода.
5. Не пить сырую воду of арыков и открытых водоёмов.
6. В группах риска — периодическое УЗИ печени.