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Verfasst von:Stojković, Marija [VerfasserIn]   i
 Mickan, Christina [VerfasserIn]   i
 Weber, Tim [VerfasserIn]   i
 Junghanss, Thomas [VerfasserIn]   i
Titel:Pitfalls in diagnosis and treatment of alveolar echinococcosis
Titelzusatz:a sentinel case series
Verf.angabe:M. Stojkovic, C. Mickan, TF Weber, T. Junghanss
E-Jahr:2015
Jahr:December 31, 2015
Fussnoten:Gesehen am 23.06.2020
Titel Quelle:Enthalten in: BMJ open gastroenterology
Ort Quelle:London : BMJ Publishing Group, 2014
Jahr Quelle:2015
Band/Heft Quelle:2(2015,1) Artikel-Nummer e000036, 6 Seiten
ISSN Quelle:2054-4774
Abstract:Background Alveolar echinococcosis (AE) is a neglected zoonosis presenting with focal liver lesions (FLL) with a wide range of imaging patterns resembling benign as well as malignant FLLs. Complementary serology and histopathology may be misleading. - Objective The objective of our study is to highlight pitfalls leading to wrong diagnoses and harmful interventions in patients with AE. - Design This retrospective sentinel case series analyses diagnostic and treatment data of patients with confirmed AE. - Results 80 patients treated between 1999 and 2014 were included in the study. In 26/80 patients treatment decisions were based on a wrong diagnosis. AE was mistaken for cystic echinococcosis (CE) in 12/26 patients followed by cholangiocellular carcinoma (CCA) in 5/26 patients; 61/80 patients had predominantly infiltrative liver lesions and 19/80 patients had a predominantly pseudocystic radiological presentation. Serology correctly differentiated between Echinococcus multilocularis and Echinococcus granulosus in 53/80 patients. Histopathology reports attributed the right Echinococcus species in 25/58 patients but failed to differentiate E. multilocularis from E. granulosus in 25/58 patients. Although contraindicated in AE 8/25 patients treated surgically had instillation of a protoscolicidal agent intraoperatively. One of the eight patients developed toxic cholangitis and liver failure and died 1 year after liver transplantation. - Conclusions Misclassification of AE leads to a critical delay in growth inhibiting benzimidazole treatment, surgical overtreatment and bares the risk of liver failure if protoscolicidal agents are instilled in AE pseudocysts.
DOI:doi:10.1136/bmjgast-2015-000036
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext ; Verlag: https://doi.org/10.1136/bmjgast-2015-000036
 Volltext: https://bmjopengastro.bmj.com/content/2/1/e000036
 DOI: https://doi.org/10.1136/bmjgast-2015-000036
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:HEPATOBILIARY PATHOLOGY
 HEPATOBILIARY RADIOLOGY
 INFECTIOUS DISEASE
K10plus-PPN:1701983087
Verknüpfungen:→ Zeitschrift

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