Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Diagnosis and treatment of mixed infection of hepatic cystic and alveolar echinococcosis: Four case reports
Ji-De A, Jin-Ping Chai, Hao Wang, Wei Gao, Zhe Peng, Shun-Yun Zhao, Xiang-Ren A
Ji-De A, Wei Gao, Zhe Peng, Shun-Yun Zhao, General Surgery, Provincial People's Hospital, Xining 810000, Qinghai Province, China
Jin-Ping Chai, Internal Medicine-Cardiovascular, Provincial People's Hospital, Xining 810000, Qinghai Province, China
Hao Wang, ICU, Provincial People's Hospital, Xining 810000, Qinghai Province, China
Xiang-Ren A, Department of Clinical Laboratory, Provincial People's Hospital, Xining 810007, Qinghai Province, China
Xiang-Ren A, Department of Clinical Laboratory, Qinghai Province Key Laboratory of Laboratory Medicine, Xining 810007, Qinghai Province, China
Xiang-Ren A, Department of Clinical Laboratory, Qinghai Clinical Medical Research Center, Xining 810007, Qinghai Province, China
Author contributions: A JD and Chai JP contributed equally to this article; A JD, Chai JP, Wang H, Zhao SY, Gao W, Peng Z and A XR contributed to the conception and design of the study; A JD and Chai JP organized the database; A JD wrote the first draft of the manuscript; Chai JP wrote sections of the manuscript; All authors contributed to manuscript revision and read and approved the submitted version.
Supported by Qinghai Provincial Health Planning System Guidance Program, No. 2017-wjzdx-23.
Informed consent statement: The patients in this study were willing to share their medical data, and they tried their best to provide informed consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiang-Ren A, BSc, Doctor, Department of Clinical Laboratory, Provincial People's Hospital, Department of Clinical Laboratory, Qinghai Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, Qinghai Clinical Medical Research Center, No. 2 Gonghe Road, Chengdong District, Xining 810000, Qinghai Province, China. xiangrena_001@163.com
Received: April 3, 2020
Peer-review started: April 3, 2020
First decision: April 24, 2020
Revised: May 4, 2020
Accepted: July 15, 2020
Article in press: July 15, 2020
Published online: September 6, 2020
Processing time: 154 Days and 2.8 Hours
BACKGROUND
Mixed infection of hepatic cystic and alveolar echinococcosis is extremely rare. This article reveals the typical imaging manifestations of cystic and alveolar echinococcosis and investigates the diagnosis and surgical experience of mixed infection of hepatic cystic and alveolar echinococcosis.
CASE SUMMARY
From January 2017 to May 2019, 4 cases with rare mixed infection of hepatic cystic and alveolar echinococcosis were admitted and treated by the Division of General Surgery of Qinghai Provincial People's Hospital. Three of the patients occasionally had upper abdominal discomfort, but it did not affect their daily lives. However, hepatic echinococcosis was found in one patient by physical examination, and the patient had no discomfort. All 4 cases were Tibetans who had lived in pastoral areas of southern Qinghai for a long time. Enzyme-linked immunosorbent assay for echinococcosis was positive for all patients. Moreover, abdominal computed tomography showed typical imaging manifestations of cystic and alveolar echinococcosis including coexisting “honeycomb sign,” and “spotted calcification.” Three of the patients underwent radical resection, and 1 case underwent palliative resection. All 4 patients developed different types of surgical complications after the operation, but all of them recovered and were discharged after symptomatic treatment.
CONCLUSION
There are no problems diagnosing mixed infection of hepatic cystic and alveolar echinococcosis. The difficulties involve preoperative evaluation and treatment of surgical complications.
Core tip: Mixed infection of hepatic cystic and alveolar echinococcosis is extremely rare. This article reveals the typical imaging manifestations of cystic and alveolar echinococcosis including coexisting “honeycomb sign” and “spotted calcification.”
