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Published on: September 16, 2022
Pancreatic echinococcosis in a 5-year-old girl
Guillermo Moscatelli1, Fabián Salgueiro1, Samanta Moroni1
1Department of Parasitology and Chagas Disease, Hospital de Niños Dr. Ricardo Gutiérrez. Multidisciplinary Institute for Research in Pediatric Diseases (Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas, IMIPP) - National Scientific and Technical Research Council (Consejo Nacional de Investigaciones Científicas y Tecnológicas, CONICET) - Government of the City of Buenos Aires, City of Buenos Aires, Argentina.
Insights
Pediatric pancreatic echinococcosis is rare but serious. This case highlights successful surgical management and albendazole treatment in a 5-year-old girl, preventing complications from this parasitic liver disease.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Infectious Diseases
Background:
- Pancreatic echinococcosis is a rare parasitic infection, typically affecting children.
- Surgical intervention is often necessary due to potential complications.
- Albendazole is crucial for preventing disease dissemination.
Observation:
- A 5-year-old girl presented with abdominal pain and a pancreatic cystic lesion.
- Imaging revealed bile duct compression, and laboratory tests showed elevated bilirubin and liver enzymes.
- Indirect hemagglutination test was negative.
Findings:
- Surgical management included exploratory laparotomy, cholecystectomy, and cyst unroofing.
- The patient experienced a favorable post-operative course.
- Post-surgical albendazole treatment was administered for 3 months.
Implications:
- This case underscores the importance of early diagnosis and multidisciplinary management of pediatric pancreatic echinococcosis.
- Combined surgical and medical therapy can lead to successful outcomes.
- Effective treatment strategies are vital for preventing long-term complications in affected children.
Abstract:
Pancreatic echinococcosis accounts for 0.2-0.6% of cases, with the pediatric population being at a higher risk. Most commonly, pancreatic lesions occur in the head of the pancreas (50-58%); and in the body and tail in 24-34% and 19% of cases, respectively. Given the potential complications, surgery is usually performed. Albendazole is recommended before and after the surgery due to the risks for rupture and dissemination of protoscolices. Here we describe the case of a 5-year-old girl with progressive abdominalpain and cystic lesion in the pancreas compatible with echinococcosis in the ultrasound. The computed tomography showed bile duct compression. Indirect hemagglutination was negative. She had elevated total bilirubin, with a clear predominance of direct bilirubin, and high liver enzymes. Exploratory laparotomy, cholecystectomy, and unroofing of the cyst were performed. The patient had a favorable course and continued with albendazole for 3 months after the surgery.
