Perspective Chapter: Primary Cystic Echinococcosis of the Pancreas

Abstract

Primary cystic echinococcosis of the pancreas is rare, even in endemic regions. The clinical presentation depends on the affected part of the pancreas and the presence of local complications, but there are no specific symptoms, which can be a clue to diagnosis. Imaging studies usually reveal avascular lesions in the pancreas that are most frequently misdiagnosed as pseudocysts or neoplastic cystic tumors. The treatment options vary from evacuation and drainage to formal resection of the pancreas, with no evidence of the best treatment strategy. This chapter provides a comprehensive review of the current knowledge of the clinical presentation, diagnosis, and treatment of primary cystic echinococcosis of the pancreas. Acute thrombosis of the splenic artery which leads to massive splenic infarction and abscess, a previously unreported initial manifestation of cystic echinococcosis of the pancreas is also presented, as well as the first use of intraoperative pancreaticoscopy to clear the mean pancreatic duct from membranes of the parasite.