Helminthiases / / August 12, 2017
Bones affected echinococcosis is rare, only 0,4-3,2% of cases.Most susceptible echinococcosis spine and pelvis, which accounted for 50-70% of lesions of bones.
hexacanth parasites get into the bone with a current of arterial blood from the systemic circulation, and begin to develop in the bone spaces.In long bones are usually deposited in the zone epimetafizarnoy most vascularized bone part.The growth of hydatid cysts in bones is particularly sharply distinguishing it from the growth of cysts in all other organs.The bone around the parasitic cysts are not formed fibrous sheath, therefore, meeting at its development obstacle by trabecular bone cyst as it is pressed between the two.At the same time its shell broken and there is colonization of adjacent bone portions.Therefore cyst has no other normal organs rounded.Thus, echinococci bone is a combination of primary and secondary lesions hydatid.
secondary hydatid disease of bone (in its pure form) can also occur.He observed occasionally when the penetra
parasitic cyst growth amplified pressure on its surrounding portions of bone that leads to destruction and necrosis with formation of seizures.Constantly progressing, hydatid captures all large areas of bone.Eventually, this can lead to complete destruction of the bone.Pathological fracture that occurs in such cases, is accompanied by the opening of hydatid bladders and colonization of the surrounding tissues.In its place are often formed long-term healing fistulas.On cross-sawing bone and spongy bone marrow cavity of her busy usually a large number of bubbles having a different value.The walls of their close contact with each other, sometimes separated by thinned bone rungs.In some cases, the bones found in large bubbles, containing up to 2.5 liters.liquid
parasitic cysts in the process of growth, not only leads to extensive destruction of the affected bone, but sometimes extends to the articular cartilage and adjacent bone, and may extend beyond the bone in the surrounding soft tissue.
in flat bones (skull, sternum, pelvis) are easily formed Uzury promoting the penetration of the parasite into the corresponding cavity and the defeat of the neighboring organs, which significantly aggravates the condition of patients, complicating treatment and worsens the prognosis.
Echinococcus bone is characterized by particularly slow growth and so the disease can last for several years.
stages of the disease
There are 4 stages of the disease.
first stage lasts from the moment of entering hexacanth before the first symptoms of the disease it has no clinical and radiological manifestations.
The second stage is characterized by the appearance of pain, lameness, thickening of the affected bone, in which the X-ray revealed a different cavity sizes.
third stage characterized by the further progression of the disease: pain intensified, increased bone destruction, there are pathological fractures, affects the surrounding soft tissue.Patients are forced to use a cane, crutches.
fourth stage appears significant deformation of the bones, the spread of the process, to neighboring bones with impaired function of the affected joints.Possible pathological dislocations.In connection with the accession of infection festering fistula formed, of which the elements are allocated echinococcus.
ehvnokokkoza bones, according to the unanimous opinion of the authors, is difficult, especially in the early period.The true nature of the lesion in most cases set only during the operation, undertaken at a different diagnosis.This is due primarily to the absence of symptoms in the early stages.In addition, the disease often proceeds as malignant tumors or chronic osteomyelitis.Finally, surgeons simply forget about the possibility of parasitic lesions of bone.
the early stages of the disease should be differentiated from an abscess Brodie enhondromy, eosinophilic granuloma, Chondroblastoma, neosteogennoy fibroma, at a far advanced forms - from osteoblastoklastomy, fibrous dysplasia, chondromatosis, chondrosarcoma, cancer metastasis.Hallmarks of tapeworm can be considered a long-term steady flow process, uniform swelling of the affected bone area in all directions, but not in one place, honeycomb or polycyclic nature of the lesion in the metaphyseal area and large individual vacuum stations, filling the medullary canal and thinner cortex in the diaphysis.Some importance may be the surrounding bone sclerosis in the presence of an inflammatory component.
- Echinococcosis abdominal
- Echinococcosis of liver
- changes in the liver with liver echinococcosis
- Symptoms of liver echinococcosis
- treatment echinococcosis of liver
- echinococcosis gallbladder
- echinococcosis spleen
- Multiple hydatid disease of the abdomen and pelvis
- echinococcosis kidney
Surgical treatment givenbenign nature of the disease in its early stages can be savings.Intervention should be a broad trepanation bone in the lesion and carefully removing the skins echinococcus.
operational manual should be more radical With widespread lesions.In the interest of the articular end of the bone make it resection followed by osteoplastic replacement defect.
In the fourth stage of the disease, with the defeat of a few bones and released osteomyelitis, sometimes you have to resort to amputation or disarticulation.If the process is moved to the other half of the pelvis or sacrum, Palliative surgery to reduce the inflammatory process.