Echinococcosis of the liver: symptoms and treatment
Echinococcosis of the liver is a chronic disease caused by parasitic worms, which can last more than six months. It is the formation of cysts on the surface of the liver. The defeat of this body is more than fifty percent of all cases of detection of echinococcosis. There are several varieties of the disease on which its course depends.
Infection with such a parasite often occurs from domestic animals, in particular from dogs, if hygiene rules are not respected. The microorganism enters the human body through the oral cavity, causing infection to occur if the eggs of the parasite are left on their hands and have been eaten from them. In addition, you can get infected by using unwashed fruits and vegetables, as well as drinking natural water that can contain a similar helminth.
The main symptoms of liver echinococcosis are a significant decrease in body weight, discomfort in the liver, diarrhea, attacks of severe nausea after eating excessively fatty and spicy foods, and general weakness of the body. To establish the final diagnosis, several laboratory-instrumental studies of the patient are used. In particular, the study of the general and biochemical analysis of blood and urine, ultrasound, CT, MRI, radiography and liver biopsy.
Treatment of such a disorder consists of a whole complex of means — dietary intake, medication intake and surgical intervention. If untimely therapy develops many complications that can lead to disability or death.
The main factor of the disease is the penetration into the body of echinococcus — a microorganism-parasite, which is forced to change the hosts, the last of which is a person. There are several ways to get echinococcus into the human liver:
- failure to comply with personal hygiene rules after contact with dogs. Often the bearers of the worm are mongrels, but the owners of pets are also threatened with parasite infestation, because animals can carry it on their wool;
- Consuming growing in wild or unwashed vegetables and fruits, as well as drinking water from natural sources. This is the most common cause of infection of children
- hunting for wild animals that are an intermediate host of the tapeworm. Infection occurs during the carcass splitting, through the coat or injured organs, and also because of eating the meat of the infected animal without adequate heat treatment.
In addition, the risk group consists of people who in one way or another contact with farm animals.
First, the eggs of parasites enter the stomach, after which the capillaries of the liver reach the bloodstream, in which their reproduction takes place. This process can last quite a long time, ranging from five weeks to fifteen years (depending on the type of illness). The worm itself is small in size, but leads to the formation of an echinococcal cyst from one to fifty centimeters. A thick capsule of the fibrous structure forms around the neoplasm. The size of the cyst depends on the severity of the course of the disease (their number is not limited).
Gastroenterology knows several forms of the course of liver echinococcosis:
- Cystic — at an early stage of development is not expressed by any symptoms. Clinical manifestations arise only when the neoplasm reaches a large size. Characteristic signs begin to appear in the form of constant minor pain in the right hypochondrium. With giant cysts swelling of the anterior wall of the abdominal cavity in this area is observed
- alveolar — differs by a longer course, more than ten years. At the initial stages of development also does not show symptoms. The main sign of this type of disorder is jaundice.
In addition to liver damage, microorganisms can cause kidney, brain, bowel, lung, mediastinum, bones and mammary gland pathologies.
In addition, there are several degrees of the disease, characterized by the formation of an echinococcal cyst of the liver:
- Initial — No symptoms are noted. Depending on the form of the ailment lasts from several weeks to fifteen years;
- of moderate severity — there is a slight expression of symptoms, without pain during palpation. Inside the body, the liver cyst grows, which causes the squeezing of nearby internal organs;
- severe — the symptoms are very clear, there are complications.
Echinococcus disease of the liver is a chronic disease characterized by the absence of expression of signs at the initial stages of development. The symptomatology begins to appear when the cystic neoplasm reaches a large volume. The intensity of expression of signs increases depending on the stage of the disease.
At the first stage, from the moment of penetration into the body of the worm until the appearance of the first signs, there are no complaints, and small cysts are found absolutely randomly, in the diagnosis of completely different disorders. The only manifestation is the appearance of urticaria, accompanied by itching and burning.
At the second stage of the course, an expression of liver damage is observed. Thus, the symptoms of liver echinococcosis are:
- bouts of nausea and vomiting that occur after eating certain foods, in particular acute, greasy or saline
- occurrence of a feeling of heaviness in the right hypochondrium and unstable pain at the top of the abdomen. The expression of such signs occurs after eating or heavy physical exertion;
- heartburn and development on her cough background
- diarrhea with a change in color of fecal masses — is formed against the background of a violation of bile secretion.
The examination reveals a significant increase in the size of the affected organ.
When the disease occurs in the third stage, progression of complications occurs. These are:
- suppuration and rupture of the cyst
- liver failure associated with impaired normal functioning
- the appearance of a yellow hue on the skin and mucous membranes
The nonspecific symptoms of the pathological effects of liver echinococcus include — a decrease or a complete lack of appetite, which entails a strong loss of body weight, as well as increased fatigue and weakness of the body. In addition, a secondary liver away from the liver can form.
In addition to the above complications, which are formed during a severe course of the disease, there are a number of consequences that develop in the absence of adequate treatment:
- amyloid deposition;
- development of an abscess;
- liver cirrhosis
- massive internal hemorrhage;
- Epilepsy attacks — when the tumor affects the central nervous system
- ventricular rupture of the heart
- anaphylactic shock
- the spread of echinococcus to other internal organs
- a significant expression of allergic reactions;
- loss of consciousness
- total loss of vision;
- formation of small formations in the form of a ball, after removal of the tumor;
- accumulation of a large amount of fluid in the abdominal cavity.
Such complications and consequences can lead to disability or death of a person.
What is a liver echinococcosis? A gastroenterologist knows the doctor, who carries out diagnostics and prescribes complex therapy for the disease. To establish the correct diagnosis, several laboratory and instrumental examinations of the patient are required. But before this it is necessary to conduct several manipulations to the attending physician:
- study the medical history and history of life — to identify predisposing causes for the formation of such a disease
- conduct a thorough examination, which includes palpation of the anterior wall of the abdominal cavity in the right hypochondrium, as well as the examination of the skin and mucous membranes. This is done to detect the intensity of the manifestation of symptoms, which will help the specialist to determine the extent of the disease. In addition, it is very important to find out the first time the appearance of clinical signs of liver echinococcosis.
Then the doctor assigns the performance of laboratory studies:
- blood — general and biochemical analysis. The procedure allows you to detect changes in its composition;
- urines — necessary to identify parasite particles
- sputum is performed to detect the presence of a tapeworm;
- Various immunological tests necessary to detect antibodies to the pathogen
Instrumental techniques for diagnosing liver echinococcosis include the following:
- Ultrasound — makes it possible to detect cysts and determine the exact location of their localization, quantity and volume
- MRI is a method for detecting pathological changes in soft tissues
- CT — to determine the size of the lesions, their structure and density
- biopsy — picking up a small piece of the affected organ for subsequent histological examinations.
Often during the diagnosis, laparoscopy is used, which allows direct examination of the abdominal organs with a video endoscope.
Elimination of such a disease consists in carrying out a whole complex of therapy, in particular:
- the appointment of dietary meals, with the exception of fatty and spicy dishes. It is recommended to consume a large amount of easily digestible proteins and enrich the food with vitamin complexes and minerals
- use of medicines
- medical intervention.
Medical treatment of liver echinococcosis consists of taking painkillers and antiemetics, funds for the renewal and strengthening of the protective functions of liver tissue. The use of anti-inflammatory drugs to treat such a disease is ineffective, but they are prescribed in order to prevent the spread of the parasite in the body and prevent the infection of other organs. It is also necessary to use them during and after medical intervention.
Surgical treatment of liver echinococcosis consists of performing several types of operations:
- radical — are the removal of the cyst along with the affected area of the liver
- conditionally radical — only the neoplasm is removed and the treated area is treated with antiseptic substances. In such cases there is a chance of relapse of echinococcus disease of the liver
- palliative — in which there is no complete cure, but only improves the general condition of the patient. For this, chemotherapy and exposure to low temperatures can be used;
- interventions to eliminate the consequences. The choice of surgery is based on the presence of a complication.
Often it is possible to achieve complete cure of the disease with the help of surgical intervention. Relapse of the disease occurs rarely.
Preventive measures against such an ailment consist in preventing the parasite from entering the body. To do this:
- observe personal hygiene after contact with dogs
- Wash hands thoroughly before eating
- a regular survey of people whose work is related to hunting and agriculture
- exclude the consumption of water from natural sources, as well as eating dirty fruits and vegetables
- perform a full-scale thermal processing of meat
The prognosis of such a disorder with timely treatment is favorable. In cases of complications, liver echinococcosis can lead to disability or death.