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Muscle-Sparing Approach for Recurrent Hydatidosis of the Thigh and Psoas: Report of a Rare Case

Public Library of Science
Publication Date
DOI: 10.1371/journal.pntd.0000840
  • Symposium
  • Infectious Diseases/Helminth Infections
  • Surgery
  • Medicine


pntd.0000840 1..3 Symposium Muscle-Sparing Approach for Recurrent Hydatidosis of the Thigh and Psoas: Report of a Rare Case Gaetano La Greca*, Elia Pulvirenti, Salvatrice Gagliardo, Maria Sofia, Domenico Russello Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Cannizzaro Hospital, Catania, Italy Presentation of Case A 46-year-old male shepherd presented with a mildly painful mass 4.5 cm in diameter localized at the right groin and thigh, diffuse edema involving the right leg lasting for 2 weeks, and fever. The patient had had eight previous operations for diffuse hydatidosis with reported intraper- itoneal seeding, but further information was unavailable. Laboratory tests are shown in Table 1. An abdominal ultrasound (US) and a Doppler US of the right leg detected the presence of multiple and partially confluent cysts localized up to the Scarpa’s triangle. A computed tomography (CT) scan detected a multi-cystic 18-cm mass originating from the psoas muscle (Figure 1, I and II). Other cysts were localized deeply and behind the muscular aponeurotic plane of the femoral quadriceps and abductor muscles (Figure 1, III and IV). All these findings were sug- gestive of diffuse hydatidosis and the patient was promptly operated on with a muscle- sparing approach, for which a written consent was obtained. Piperacillin/tazobactam was adminis- tered from the date of admission to the day of surgery. Preoperative prophylaxis with benzimidazole derivatives was not performed due to the extent of the disease, the history of recurrences, and the need to perform the operation promptly to reduce the symptoms. At surgery, the retroperitoneum was accessed and tissues surrounding the cysts were covered with sponges soaked with hypertonic saline. The cystic content was evacuated and the interior of the cyst was repeatedly washed with protoscolicides. Due to the tight adhesions wi

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