تشخيص پارگي هاي مخفي كيست هيداتيد به مجاري صفراوي

Clinical and paraclinical findings related to the rupture of hydatid cyst into the liver biliary ducts

The rupture of hydatid cyst into the intra-hepatic bile ducts is consid­ered as one of the problematic and important hydatid side effects. Considering the fact that this parasite is endemic in Iran, detection and treatment of hydatid cyst ruptured into the biliary system is crucial for any surgeon. Failure in detecting and predicting this complication can result in irremediable consequences. This study was retrospective and included 196 patients with liver hy­datid cyst who were surgically operated (1994-2005) in hospitals of Isfahan University of Medical Sciences (Kashani Hospital, Isabne Ma- ryam hospital and Al-Zahra Hospital) by the researcher, and among them, 22 patients were excluded because of incomplete records or lack of the conditions required for entering the study, and finally 174 pa­tients were selected for the study. The quantitative and qualitative data were analyzed by /-test and Fisherʹs exact test respectively, also with Pearson test when necessary, at the statistical significant level of P< 0.05 in SPSS-10 software. Background: Methods: Findings: Conclusion: Key words: Page count: Tables: Figures: References: Address of Corre­spondence: Laboratory findings in patients with liver hydatid rupture was as fol­lows: total bilirubin more than 1 mg/dl (p < 0.05), direct bilirubin more than 0.4 mg/dl (p < 0.05), alanine aminotransferase more than 31.5 u/1 (p < 0.05), aspartate aminotransferase more than 29.5 u/1 (p < 0.05), jaundice in last two weeks (p < 0.05), cyst size more than 14.5 cm (p < 0.05) and alkaline phosphatase more than 275.5 u/1 (p < 0.05). Age, gender, white cell count, and cyst size smaller than 10 cm were insignificant and non helpful in making the diagnosis. In cases that rupture of liver hydatid cyst cannot be detected by ultra­sonography, surgeon must be careful during the operation in explora­tion for detection of probable rupture of liver hydatid cyst to provide the necessary treatments during the cyst operation and to prevent fur­ther operations and side effects.