Hydatid cyst of the liver, a clinical and therapeutic approach on 97 cases treated by surgery

Objective - The hydatid cyst of the liver, an anthropozoonosis due to a cestode (Echinococcus granulosus), the usual host of which is the dog, is not common in Western Europe, but has been diagnosed in patients coming from Southern Europe and Northern Africa. This retrospective study describes the clinical, diagnostic, and therapeutic aspects of the hydatid echinococcosis. Material and methods - We examined the evolution of 97 consecutive patients admitted and treated surgically for a hydatid cyst in 1998 in a Central Tunisia university hospital. Results - The patients' mean age was 41 ± 19.8 years (range: 4 and 85). The most common cause for consulting a physician was pain (79.4 %), usually located in the right upper quadrant. Sometimes, the disease occurred with the onset of serious complications. In some cases it was also discovered fortuitously. The most sensitive diagnostic method was abdominal echotomography, positive in every case. Serology and TD scan were also performed in some cases. The treatment was surgery with two methods: a radical and a conservative one; 16.5 % of postoperative complications are reported for both techniques (fistula and surinfection). Conclusion - The hydatid disease of the liver is a histologically benign pathology, but it may become dangerous because of possible serious complications. Although there are efficacious therapeutic weapons, prevention and education of the population living in endemic zones is strongly advised. (C) 2000 Editions scientifiques et medicales Elsevier SAS.