Nonsurgical Treatment of Cystic Echinococcosis
Author(s):
Abstract:
The history of medical treatment of echinococcosis is intimately related to development and use of benzimidazole carbamates (e.g., mebendazole, albendazole, etc.) as a safe and effective class of ant parasitic drugs. The most important side effects include abnormality in liver enzymes, hair loss, drug allergy, bone marrow suppression and etc. Factors predicting the cyst�s response to treatment are size, site and dosage and method of use of the drug. Relapses occur in 3-25% of patients, the majority occurs within first two years. There are a few contraindications to the medical therapy of hydatid cyst, including: pregnancy, bone marrow suppression, liver diseases, diabetes mellitus and some cyst characteristics such as size and location of some of cysts. Another nonsurgical therapy mode of treatment is ultrasound guided percutanous drainage and treatment (PAIR =Puncture of the cyst, rapid Aspiration of the cyst contents, Injection of a scolicidal agent to cavity and Reaspiration of cyst contents). Due to complications of this method (e.g., rapture, anaphylaxis, etc.) a few premedications are needed such as antibiotics, corticosteroids and antihistamines. Main side effects of percutanous drainage include: allergic reaction, fever and infection, dissemination and local recurrence, biliary fistulas, biliary rapture and obstruction and caustic sclerosing cholangitis. Contraindications to PAIR are: inaccessible or superficially located hepatic cysts, inactive or calcified cysts, pulmonary cysts, cysts with dominant nondrainable material and those cysts with communications with biliary tree or with multiple septations (relative). Percutanous drug injection without aspiration is the most recent modality, which is under investigation.
Language:
English
Published:
Shiraz Emedical Journal, Volume:4 Issue: 1, Jan 2003
Page:
2
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