Coinfection with hepatic cystic and alveolar echinococcosis with abdominal wall abscess and sinus tract formation: A case report

Table 1 Clinical data of five patients

No.	Sex	Age (yr)	Lesion (location)	Child-Pugh score	Surgery	Postoperative complication	Case characteristics
1	Female	42	S5 and S8	A	Anatomic right hemihepatectomy	No	Surgical treatment of patients with preoperative misdiagnosis of echinococcosis and mixed infections of both types of echinococcosis should be based on ensuring the patient's surgical safety, and radical surgery should be performed to remove all lesions whenever possible
2	Female	26	S4, S5 and S8	A	Removal of the internal capsule, with subtotal excision of the external capsule the in Echinococcus granulosus lesions	Bile leakage, ascites, and bilateral pleural effusions	The patient traveled to an out-of-state hospital for autologous liver transplantation. Staged surgical treatment may be considered in end-stage patients with insufficient residual liver volume or in advanced patients who cannot be completely resected at one time, and only palliative surgery or conservative treatment is required for patients who have lost the chance of radical surgical treatment
3	Female	49	S2, S3, S7 and S8	A	Multiple segmental hepatectomy	No	Surgical treatment of patients with preoperative misdiagnosis of echinococcosis and mixed infections of both types of echinococcosis should be based on ensuring the patient's surgical safety, and radical surgery should be performed to remove all lesions whenever possible
4	Male	56	S4, S5, S6, S7 and S8	A	Extended right hemicolectomy	No	Ultrasound-guided PTCD for jaundice reduction was performed on day 2 of admission, and jaundice was reduced until surgery on day 33 after admission
5	Female	39	S6 and S7	A	Multiple hepatic segment resection with abdominal wall sinus resection	No	Misdiagnosed preoperatively as echinococcosis, intraoperative and postoperative pathology confirmed mixed infection of the two types of echinococcosis in the liver with abdominal wall abscesses and sinus tracts, and the surgery needed to be considered as radical resection of the lesions, sinus tracts, and abdominal wall abscesses, which in turn followed the principle of individualized treatment of echinococcosis

PTCD: Percutaneous transhepatic biliary drainage; S: Segment (Couinaud's segmentation method divides the liver into eight segments according to anatomical position).