Treatment of a giant hepatic echinococcal cyst with percutaneous drainage and in vivo assessment of the protoscolicidal effect of praziquantel

• DOI: 10.1007/s12328-021-01397-4
• Publication Date: 2021-04-13T19:08:51Z
• Authors: Joachim Richter; Andreas Karl Lindner; Dominik Geisel; Giovanni Federico...; Gabriela Equihua ...; Caroline Isner; Dirk Schürmann; Frieder Pfäfflin; Arzu Orhun; Tommaso Manciulli; Enrico Brunetti
• Keywords: Albendazole; Interventional radiology

Abstract Therapy choices for cystic echinococcisis (CE) are stage-specific: surgical, minimally invasive, medical or observation without intervention. PAIR (percutaneous aspiration, instillation of a scolicide, and re-aspiration) has been considered the treatment choice uncomplicated echinococcal liver cysts. However, carries risk toxic cholangitis hypernatremia that cyst frequently refills with bile after withdrawing catheter. We treated patient giant CE 1 puncture drainage (PD) under albendazole coverage. Drainage enabled us to monitor morphology protoscolices praziquantel (PZQ) co-medication. Protoscolices degenerated within 5 days PZQ 50 mg/kg/d. The cavity solidified no evidence reactivation secondary spread. Percutaneous treatments can replace surgery in significant number cases hepatic CE. PD allows assess microscopically viability co-medication PZQ–albendazole avoid topical scolicides.