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Re: Echinococcal cyst in pregnancy From: art fougner, md (evsono@pipeline.com) Tue Feb 28 11:49:37 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: Gyn: Our friends, the ureters" Previous message: Jamie: "Re: The Death of the Canadian Model" In reply to: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Echinococcal cyst in pregnancy" Next in thread: GA12L@aol.com: "Re: Echinococcal cyst in pregnancy" No personal experience but I did find this: * Antiparasitic chemotherapy o The basic medical treatment is chemotherapy with benzimidazoles (eg, mebendazole, albendazole) at high doses. o According to the 1996 WHO Informal Working Group on Echinococcosis, long-term chemotherapy (for several years, possibly for life) is mandatory in inoperable patients. The decision to withdraw treatment is particularly difficult without objective and irrefutable proof of definitive cure. o Complementary chemotherapy is mandatory for at least 2 years following surgery. Careful follow-up examinations in these patients must continue for at least 10 years. In all cases of palliative operations, either surgical or ultrasonographically guided, chemotherapy is mandatory and follows the same therapeutic schedule as for patients who have not had operations. o Administer chemotherapy for at least 2 years after radical liver transplantation and for life in patients who demonstrate evidence of parasitic remnants in the liver area and/or of distant metastases outside the liver. http://www.emedicine.com/med/topic326.htm I'll bet Steve or el will be able to weigh in on clinical experience. Art At Tue, 28 Feb 2006, Elrod, Darryl G MAJ 48 MDOS/SGOBO wrote: > >Group, > >We have just had a 26 yo G2P1 at 19 wks present with diffuse abdominal >pain, vomiting, WBC count of 17K. Her workup included abdominal >ultrasound that showed a 12 cm liver cyst, c/w echinococcal cyst. CT >scan the next morning (today) showed probable rupture of this cyst with >an increased amount of free fluid. > >Because her temperature increased to 101, her WBC count increased to 19K >and the findings of the CT scan, the general surgeons decided to operate >and drain the cyst. > >At surgery, there was free fluid noted. The cyst was indeed ruptured >through a small hole. 150ml of clear fluid was removed from the cyst. >The cyst was opened and a large amount of white opaque gelatinous tissue >was removed. There were also noted some typical echinococcal cysts. > >My question for the group is more a question of management for the >remainder of the pregnancy. Treatment options appear to be mebendazole >or albendazole for 3-6 months. Both of these are listed as Category C >drugs and Reprotox shows possibly some benefit of mebendazole over >albendazole, but mostly for first trimester exposure. > >Has anyone continued drug therapy for this long or have experience at >all with treating this? > >Thanks, > >Glen > >//SIGNED// > >D. Glen Elrod, Maj., USAF, MC > >Obstetrician/Gynecologist > >Chief of Obstetrics > >48 MDOS/SGOBO > >RAF Lakenheath, England > >Telephone DSN: 314-226-8130 > > Comm: +44 (0) 1638 52 8130 > >Notice of Confidentiality >Under the Privacy Act of 1974, you must safeguard all information >reflected on this e-mail and, if applicable, all attachments. >Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI >37-132, AFI 33-219, and PL 93-579" >This e-mail message including any attachments is for the sole use of the >intended recipient(s) and may contain confidential and privileged >information. Any unauthorized review, use, disclosure or distribution is >prohibited. If you are not the intended recipient, please contact the >sender by reply e-mail and destroy all copies of the original message. >Any questions pertaining to disclosure should be directed to the privacy >officer. -- art fougner, md Support Free Speech Buy Danish! Next message: Garry E. Siegel, M.D.: "Re: Gyn: Our friends, the ureters" Previous message: Jamie: "Re: The Death of the Canadian Model" In reply to: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Echinococcal cyst in pregnancy" Next in thread: GA12L@aol.com: "Re: Echinococcal cyst in pregnancy"

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