Alveolar (multichamber) liver echinococcosis

If single chamber echinococcosis is a cystic education, which in a progressive growth causes pressure on the tissue of the liver and, thus, atrophy of the surrounding layers of the liver tissue, alveolar echinococcosis has similarities with the tumor growing into the fabric of the liver, leading to the death of the hepatic parenchyma. Infiltration of the latter is due to the conglomerate of tiny bubbles of echinococcosis in size from a few microns up to 0.5 cm in diameter. Insufficient blood supply if Echinococcus site is complicated by necrosis at the center of it, and sometimes melatonina. Although in the centre of parasitic tumor death reigns, the periphery it continues to live and to produce new bubbles.
Alveolar echinococcosis may germinate in the pleural cavity, in the bile ducts and in the gastrointestinal tract. Penetrate the alveolar echinococcosis into the inferior Vena cava bubbles it can break off and entered the blood stream to distant organs, giving there metastases. Mechanical jaundice I. M. Bregvadze (1962) was observed in 22% of patients. Even rarer is celebrated ascites - not more than 2-3% of cases.
For uncomplicated alveolar echinococcosis of the liver General condition of the patient suffers a little. The disease develops over many months and even years without symptoms. Temperature rise can appear at large pockets of decay and suppuration in them. Often the patient himself probing their tumor in the epigastric region and in the right hypochondrium, have the feeling of gravity in epigastria, and signs of gastric discomfort. Apparently in the liver nodes are in the nature of the "iron density" (characteristic M. N. Lyubimov). Sometimes in the centers of disintegration there is erosion of vessels followed by bleeding.
The improved diagnosis of alveolar echinococcosis is possible with the help of pneumoperitoneum, peritoneoscopy and laparoscopy. Eosinophilia was observed in 43% of cases. As with single-echinococcosis, the most valuable is the reaction of Casoni, and it can be used antigen as Galatenko and alveolar Echinococcus.
Currently, treatment of alveolar echinococcosis of the liver is to hepatectomy in healthy tissues or vilasini parasitic tumors.
In recent years in the treatment of alveolar echinococcosis of the liver planned some success. Surgical treatment of this disease becomes more effective, the previously recognized echinococcosis.
As expected, the best results are obtained when echinococcectomy and worst in palliative operations. Forecast rehabilitation after radical operations on the occasion of the alveolar echinococcosis of the liver in General are quite favorable, but, as a rule, to heavy physical work these patients no longer be returned. A return to the same work can only a small number of patients. In inoperable cases applied treatment taalem (thymol ester of palmitic acid), allowing to achieve long-term remission N. I. Tobolska and M. A. Alekseev, 1965).