Review Article
Year: 2019 | Month: February | Volume: 6 | Issue: 2 | Pages: 186-191
Scolicidal Agents and Secondary Cholangitis
Dr. Sudheer Tale1*, Dr. Srinivas Bannoth2*, Dr. Pahel Soibam Meitei3**, Dr. Mohan Kumar Hanumanthappa1*, Dr. Mrudula Kolli1#
1Senior Resident, Department of Internal Medicine, 2Senior Resident, Department of General Surgery, 3Assistant Professor, Department of Internal Medicine
*Post Graduate Institute of Medical Education and Research, Chandigarh - 160012.
**JNIMS, Imphal.
#Gandhi Medical College, Hyderabad.
Corresponding Author: Dr. Srinivas Bannoth
ABSTRACT
Aim: The aim of this study was to review different scolicidal agents in present use, side effects and newer scolicidal agents which could effectively had lethal effect on echinococcus in various in-vitro and in-vivo studies.
Methods: Various in vitro and in vivo animal and human studies had been reviewed in this study, effects of various scolicidal agents and their side effects have been presented.
Conclusion: Hypertonic saline the most commonly used scolicidal agent has potent action but is not devoid of its complications even 5% percent hypertonic saline could cause sclerosing cholangitis in rabbit model, so 20% saline which is more commonly used scolicidal could have more sclerosing effects on biliary tree in case of intra cystic communication and is also associated with hypernatremia. 10% povidone iodine had similar scolicidal effect like hypertonic saline, and its intra cystic use has shown upto 50% sclerosing cholangitis in some studies. Cetrimide a potent scolicidalagent has been associated with sclerosing cholangitis and has been reported to cause severe intra operative metabolic acidosis. Silver nitrate too showed histopathological changes in liver and biliary tract and was associated with methemoglobinemia. The new scolicidal agents being studied were hypertonic glucose solutions, 10% honey, methanolic extract of sambucus ebulus, chloroformic extract of garlic, ethanolic extracts of turmeric and ginger and black cumin seed oil have shown to be potent scolicidal agents and some of them showed that they were devoid of sclerosing cholangitis, so a further large scale and human studies are essential to reproduce these results and to evaluate their side effects. Recently used nano particles of selenium though showed scolicidal effects were associated with complications. So presently used scolicidal though they are potent in action are associated with sclerosing cholangitis, hence a careful intracystic use of them in case of intracystic biliary communication is essential. They were associated with severe cholangitis, and routine practice of use of scolicidal agent in spite of biliary cystic communication should be avoided. The newer agents which could be safe in these aspects need further large scale studies.
Key words: Scolicidal agents, Sclerosing cholangitis, Echinococcus
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