Hydatidous echinococcosis: diagnosis
Last reviewed: 23.04.2024
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Assuming echinococcosis allow clinical symptoms of hydatidosis echinococcosis (tumor-like, slowly growing formation in the liver, lungs or other organs) and epidemiological data.
Seroimmunological diagnostics of hydatidosis echinococcosis (ELISA, RIGA, RLA) gives positive results in 90% of cases and more with liver damage, with lung echinococcosis less effective (60%). Antibody titers in the early period of invasion, with unopened or medically untreated cysts may be low or the reactions give negative results. An intradermal test with an echinococcal antigen (known as the Casoni reaction) is not currently used due to the frequent development of allergic complications. Parasitologic diagnosis of hydatidosis echinococcosis is possible with the breakthrough of echinococcal cysts into the lumen of hollow organs - then scolexes or individual hooks of the parasite can be found in sputum, duodenal contents, feces.
X-ray diagnostics of hydatidosis echinococcosis, as well as ultrasound, CT and MRI allow to assess the nature and prevalence of the process. In the lungs, a rounded, often irregular form of uniform density formation is detected on the X-ray; they do not calcify, while in about 50% of cases around the cysts in the liver they reveal a ring of calcification. Small cysts are detected with the help of a tomography. Ultrasound is one of the most effective diagnostic methods for the localization of echinococcosis of the liver and abdominal cavity organs. Ultrasound, as screening, allows to determine the presence of volumetric liquid formation in the liver and hypertension in the intra- and extrahepatic bile ducts. CT and MRI have a higher resolving power. CT in complicated cases is used to clarify the localization of the cyst and its relationship with neighboring anatomical formations. The algorithm for diagnosing obstructive jaundice of echinococcal genesis must necessarily include ultrasound of the abdominal cavity, CT and RHPG with decompression of the bile ducts. In some cases, diagnostic laparoscopy is indicated (caution: puncture the cyst is impossible due to the danger of dissemination).
[Indications for consultation of other specialists
With a complicated course of hydatidid echinococcosis (rupture of cysts, compression of vital organs), a surgeon's consultation is needed to resolve the issue of surgical treatment.
Indications for hospitalization
Hospitalization and detailed diagnosis of hydatidosis echinococcosis is indicated in a complicated course of the disease.