Uğur ATA, Derya ÇAĞLAYAN, Cemil ÇELİK, Erhan KARTAL, Arzu AKÇAY

Mikrorüptüre Kist Hidatik Kaynaklı Pulmoner Parazitik Embolizasyon: Bir Otopsi Olgusu

Ekinokokkoz genellikle uzun yıllar boyunca asemptomatik kalmakla birlikte kist rüptürü, süperenfeksiyon gibi komplikasyonlar nedeniyle ölüme de neden olabilmektedir. Makroskobik olarak non-rüptüre kiste bağlı ölüm oldukça nadir olup mekanizması tam olarak bilinmemektedir. Literatürde otopsi ile tanı konulan benzer özellikte birkaç olgu bildirilmektedir. Bu otopsi olgusunda hidatik kist mikrorüptürüne bağlı olduğu değerlendirilen ölüm sunulmaktadır. Karaciğerinde rüptüre olmayan kist saptanan cesetin akciğerinin mikroskopik incelemesinde yaygın intraalveolar kanama, ödem, ağır hiperemi, interstisyel kapiller lümenlerinde nötrofil stazı, kapiller lümeninde çok sayıda parazit varlığı saptandı. Ölüm nedeninin intakt karaciğer kistlerinden kan dolaşımına sızan kist içeriğine karşı gelişen anaflaksi ve nontrombotik akciğer embolizasyonu sonucu geliştiği düşünülmüştür. Ekinokokkozun endemik olduğu ülkelerde tüm anaflaksi ve ani ölüm olgularında ayırıcı tanıda ekinokokkoz düşünülmesi gerekmektedir.

Anahtar Kelimeler:

Anafilaksi, echinococcus, karaciğer, parazitemi, ani ölüm

Pulmonary Parasitic Embolization Caused by Micro Ruptured Hydatid Cyst: An Autopsy Case

Echinococcosis generally remains asymptomatic for many years, but it can also be fatal if complications like cyst rupture or superinfection occur. It is highly uncommon for a macroscopically non-ruptured cyst to cause death, and its exact mechanism is unknown. In the literature, there are several cases with identical characteristics diagnosed by autopsy. This autopsy case has illustrated the death due to a micro ruptured hydatid cyst. The deceased's lung underwent microscopic inspection, and it revealed broad intraalveolar hemorrhage, edema, severe hyperemia, neutrophil stasis in the interstitial capillary lumens, and a large number of parasites in the capillary lumen. Anaphylaxis against cyst contents that leaked into the bloodstream from liver cysts and non-thrombotic pulmonary embolization were shown to be the causes of mortality. In countries where echinococcosis is endemic, echinococcosis should be considered in all cases of anaphylaxis and sudden death.

Keywords:

Anaphylaxis, echinococcus, liver, parasitemia, sudden death,

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