Hydatid Cyst in the Past and the Present

Abstract

BACKGROUND:Hydatid cyst is a parasitic infection that is widely endemic in India. It is a zoonotic disease with man being an accidental dead end host. Despite its world-wide affection, its diagnosis still remains a matter of challenge due to lack of an authentic gold standard for its early detection. In such cases, clinical judgment and high index of suspicion, in an endemic area is a worthy tool. AIMS AND OBJECTIVES: The study was undertaken to highlight important clinical features of hydatid cyst to help early diagnosis and management, the rare presentations of hydatid cysts in an endemic belt of Maharashtra along with their management and the shift that had occurred from past to present in hydatid cyst management along with future implications. MATERIALS AND METHODS:The hydatid cyst pattern (etiology, symptomatology, diagnosis and treatment) was retrospectively analyzed in operated hospitalized patients at three hospitals, GMC, Nagpur, VNGMC, Veotmal and MGIMS, Sewagram from 1975 to 2010 at different cross-sections of time. RESULTS: A total of 560 patients, 289 males and 271 females, who were diagnosed and operated for hydatid cyst, were evaluated. The mean age of presentation was 39.8 years with 61.9% rural population. Abdominal pain was most common compliant among symptomatic group (88.5%). Liver was most commonly involved (56.9%) followed by lung (32.7%). The most common radiological method to diagnose the disease was ultrasonography, with 91.4% accuracy, followed by CT scan. Multiple organ involvement was seen in 11.1% cases. The recurrence rate was 3.7%. There was no mortality and no serious postoperative complication other than bile leak (8.4%) and pus discharge (4.1%) from drain. Preoperative Albendazole followed by surgery and postoperative albendazole had a definite role in preventing recurrence. The mean hospital stay was 10.8 + 2.67 (3-35) days. CONCLUSION: A sound knowledge of various modes of presentation of hydatid disease, combined with clinical judgment, high suspicion in endemic areas and confirmation by newer diagnostic modalities like USG and CT is required for early diagnosis and treatment and prevent complications.

Intra-Abdominal Hydatid Cyst: Sociodemographics, Clinical Profiles, and Outcomes of Patients Operated on at a Tertiary Hospital in Addis Ababa, Ethiopia

“…This study showed IAHC to be a fairly common condition. Though the disease is considered to be common in rural settings, our finding showed a relatively higher proportion of patients to be from the urban setting [ 15 ]. Bilutse et al from a different hospital in Addis Ababa also showed 60% of their patients with HC of the liver to be from urban settings [ 6 ].…”

Hydatid disease: a 2 years retrospective study in a tertiary care center in South India

“…The life cycle of Echinococcus granulosus was first described by Haubner. [2][3][4] It is an important zoonotic and parasitic infection of humans, following ingestion of tapeworm eggs excreted in the faeces of infected dogs. 3 Echinococcosis is endemic in developing countries like South America, Middle East, Australia, India and Mediterranean countries where flocks of sheep and cattle are raised with dogs and hence more common in the rural population and with also the people involved in animal husbandry.…”

“…3 Echinococcosis is endemic in developing countries like South America, Middle East, Australia, India and Mediterranean countries where flocks of sheep and cattle are raised with dogs and hence more common in the rural population and with also the people involved in animal husbandry. 2,4,5 In India the highest prevalence is reported in Andhra Pradesh, Tamil Nadu, and Jammu and Kashmir…”

“…The sites of occurrence in descending order are liver (50-93%), lungs (18-35%), peritoneal cavity (10-16%), spleen (2-3%), kidney (1-4%), and retroperitoneum (0.5-1.5%). [2][3][4]6 After infection with Echinococcus granulosus, humans are usually asymptomatic for a long time. The growth of the cyst in the liver is variable, ranging from 1 mm to 5 mm in diameter per year.…”

“…3 Due to decreased resistance offered by alveolar loose tissue in lung parenchyma, cysts grow faster in lung than in liver. 2,7 Usually parasites spread via portal blood stream. Other routes of spread may be lymphatic invasion by the parasite, and retrograde migration from the vena cava to the subclavian vein.…”