Short Case Report
Primary Hydatid Cyst of Bladder Hydatid disease can affect any part of the body. In 75% of cases hydatid affects the liver (1st filter) and in 15% the lung (2nd filter). Brain is the 3rd most common site, and less commonly it may involve spleen, muscles, breast, thyroid, parotid and submandibular gland (Talib, 1968). Infestation of the genitourinary tract is rare, and usually affects the kidney, where the disease may be primary or secondary by involvement from adjacent viscera (Kirkland, 1966). Involvement of the bladder is most infrequent.
through two filters, i.e., liver and lung, via the systemic circulation. Most case reports in the literature are of secondary hydatid cysts. Trevor Lewis (1939) has reported a case from the vesico-prostatic junction which simulated enlargement of the prostate. Constantian and Bolduc (1968) have reported a secondary hydatid cyst of the urinary bladder which had been arising primarily from the mesentery. Talib (1966) has reported a secondary hydatid cyst directly communicating into the bladder from the broad ligament of the uterus, and he even doubted the presence of primary hydatid cyst.
Case Report A 10-year-old male resident of Nepal was admitted with complaint of a lump in the hypogastrium for 6
H. K. FULORIA, M. S. D. JAISWAL and R. V. SINGH Department of Surgery, King George's Medical College, Lucknow University, Lucknow ( U,P.)
months. On examination there was a cystic lump in the hypogastrium 16 x 13 cm which was mobile from side to side. The upper limit was well defined, and the lower limit went below the pubic symphysis. On rectal examination the lump was bimanually palpable and was well above the prostate. Catheterisation did not reduce the size of the lump. Urine examination did not reveal any abnormality. Hb. was 12 gm%. WBC count was 10,6Oo/cu mm, and differential count showed P68, L19, E13, MO.X-ray chest was normal. Plain X-ray abdomen and IVP showed a soft tissue shadow in the lower abdomen Cystogram revealed an extravesical lump which distorted the fundus of the bladder. Cystoscopy was normal. Casoni test was positive. Exploration was done by a supra-pubic transverse incision. After pushing up the peritoneum the lump was found to be attached to the fundus of the urinary bladder. The cyst was removed intact along with part of the bladder wall (Fig.). The peritoneum was opened and a search was made for a primary site in the liver, spleen, kidney, gall bladder, stomach, small bowel and large intestine, but all appeared normal. The abdomen was closed around a drain, and the patient made an uneventful recovery. On section the cyst was found to contain many cysts filled with clear fluid. Microscopically, the primary cyst contained secondary cysts in which were found scolices characteristic of E. granulosus.
References CONSTANTIAN, H. M. and BOLDUC,R. A. (1968). Echinococcus cyst simulating urachal cyst. Journal of Urology, 99, 755-758. KIRKLAND, K. (1966). Urological aspects of hydatid disease. British Journal of Urology, 38, 241-254. LEWIS,J. T.(1939). Hydatid cyst simulating enlargement of the prostate gland. British Medical Journal, 2,448. TALIB,H. (1968). Some surgical aspects of hydatid diseases in Iraq. British Journal of Surgery, 55. 576-585.
Comment Primary hydatid cyst of the urinary bladder is extremely rare, and has its origin after passing 192
Primary Hydatid Cyst of Bladder Hydatid disease can affect any part of the body. In 75% of cases hydatid affects the liver (1st filter) and in 15% the lung (2nd filter). Brain is the 3rd most common site, and less commonly it may involve spleen, muscles, breast, thyroid, parotid and submandibular gland (Talib, 1968). Infestation of the genitourinary tract is rare, and usually affects the kidney, where the disease may be primary or secondary by involvement from adjacent viscera (Kirkland, 1966). Involvement of the bladder is most infrequent.
through two filters, i.e., liver and lung, via the systemic circulation. Most case reports in the literature are of secondary hydatid cysts. Trevor Lewis (1939) has reported a case from the vesico-prostatic junction which simulated enlargement of the prostate. Constantian and Bolduc (1968) have reported a secondary hydatid cyst of the urinary bladder which had been arising primarily from the mesentery. Talib (1966) has reported a secondary hydatid cyst directly communicating into the bladder from the broad ligament of the uterus, and he even doubted the presence of primary hydatid cyst.
Case Report A 10-year-old male resident of Nepal was admitted with complaint of a lump in the hypogastrium for 6
H. K. FULORIA, M. S. D. JAISWAL and R. V. SINGH Department of Surgery, King George's Medical College, Lucknow University, Lucknow ( U,P.)
months. On examination there was a cystic lump in the hypogastrium 16 x 13 cm which was mobile from side to side. The upper limit was well defined, and the lower limit went below the pubic symphysis. On rectal examination the lump was bimanually palpable and was well above the prostate. Catheterisation did not reduce the size of the lump. Urine examination did not reveal any abnormality. Hb. was 12 gm%. WBC count was 10,6Oo/cu mm, and differential count showed P68, L19, E13, MO.X-ray chest was normal. Plain X-ray abdomen and IVP showed a soft tissue shadow in the lower abdomen Cystogram revealed an extravesical lump which distorted the fundus of the bladder. Cystoscopy was normal. Casoni test was positive. Exploration was done by a supra-pubic transverse incision. After pushing up the peritoneum the lump was found to be attached to the fundus of the urinary bladder. The cyst was removed intact along with part of the bladder wall (Fig.). The peritoneum was opened and a search was made for a primary site in the liver, spleen, kidney, gall bladder, stomach, small bowel and large intestine, but all appeared normal. The abdomen was closed around a drain, and the patient made an uneventful recovery. On section the cyst was found to contain many cysts filled with clear fluid. Microscopically, the primary cyst contained secondary cysts in which were found scolices characteristic of E. granulosus.
References CONSTANTIAN, H. M. and BOLDUC,R. A. (1968). Echinococcus cyst simulating urachal cyst. Journal of Urology, 99, 755-758. KIRKLAND, K. (1966). Urological aspects of hydatid disease. British Journal of Urology, 38, 241-254. LEWIS,J. T.(1939). Hydatid cyst simulating enlargement of the prostate gland. British Medical Journal, 2,448. TALIB,H. (1968). Some surgical aspects of hydatid diseases in Iraq. British Journal of Surgery, 55. 576-585.
Comment Primary hydatid cyst of the urinary bladder is extremely rare, and has its origin after passing 192
