Akut pankreatite neden olan pankreas kistik ekinokokkozisi

Ekinokokkosiz, genellikle Echinococcus granulosus helmintinin neden olduðu zoonotik bir enfestasyondur. Köpek ve kedi gibi etoburlar kesin konakçý iken sýðýr, koyun keçi gibi otoburlar ara konakçýdýrlar. Ýnsanlar ara konakçý olup onlarda kistik ekinokokkosize neden olurlar. Ülkemizde insidansý %14’dür. Hastalýk %70 oranýnda karaciðerde yerleþir. Kist hidatiðin pankreasa yerleþmesi sýra dýþý olup %0.2–0.6 oranýnda rastlanýr ve nadiren akut pankreatite neden olur. Bu sunumda, akut pankreatit ataðý ile kendini gösteren pankreas kist hidatiði saptanýlan 45 yaþýnda bir erkek olgu sunuldu. Ýncelemelerinde pankreas gövde-kuyruk bölgesinde 97 mm çapýnda wirsung kanalý ile iþtirakli, WHO sýnýflandýrmasýna göre CE2 tipinde evre III kist hidatik, akut pankreatit ve splenomegali saptandý. Ýndirekt hemaglütinasyon testi >1: 2560 idi. Albendazol tablet ile dört hafta týbbi tedavi sonrasýnda hastaya distal pankreatektomi ve splenektomi yapýldý. Hastanýn üçüncü ayýnda IHA sonucu 1/32 olarak bulundu. Özellikle hastalýðýn endemik olduðu coðrafi bölgelerde, pankreastaki tüm kistik kitlelerin ayýrýcý tanýsýnda kist hidatik göz önünde bulundurulmalýdýr. Ayrýca pankeas kist hidatiðinin nadir görülmesine raðmen akut pankreatite neden olabileceði akla getirilmelidir.

Pancreatic cystic echinococcosis causing acute pancreatitis

Echinococcosis is a zoonotic infestation, most commonly arises from Echinococcus granulosus helminth. The definitive hosts are carnivora, such as dogs and cats, and the intermediate hosts are herbivores, including cattle, sheep and goats. Humans are intermediate hosts, causing cystic echinococcosis. In our country, the incidence of echinococcos is 14%. The disease is localized in the liver by 70%. Cyst hydatid localized in the pancreas is unusual, with an incidence of 0.2–0.6%, and rarely causes acute pancreatitis. In this report, we present a 45-year-old male patient with cyst hydatid, which manifested by an acute pancreatitis attack. In the examination, there was a CE2 type according to WHO classification stage III cyst hydatid of 97 mm diameter with septa associated with Wirsung duct, acute pancreatitis and splenomegaly. The indirect hemagglutination test was >1: 2560. The patient underwent pancreatectomy and splenectomy following medical therapy with Albendazole tablet for four weeks. IHA of the patient was found as 1/32 in the third month. Cyst hydatid should be considered in the differential diagnosis of all cystic masses, especially in the regions where the disease is endemic. In addition, it should be remembered that although rarely seen, pancreatic cyst hydatid may cause acute pancreatitis.