Hydatid disease of the liver in children

Abstract

Between 1986 and 1997, 21 children (ten boys and 11 girls) had surgery for hydatid disease of the liver. Their mean age was 6.5 years (range 3-12). Abdominal distention with a mass was the commonest presenting symptom (71.4%), followed by abdominal pain (38%). Hepatomegaly with a palpable mass was present in 12 (57%). Three children had concomitant pulmonary and brain hydatid disease. The diagnosis was established clinically and by skin testing, serology and imaging techniques. All patients received a pre-operative course of mebendazole (50 mg/kg/day) for between 1 and 8 weeks. At surgery, 11 children had a single cyst, eight of which were in the right lobe of the liver. Ten children had multiple cysts occupying both liver lobes. Three forms of surgical treatment were used: capitonnage + partial excision of fibrous capsule; total excision of the cyst; and external drainage of the cyst cavity. Three children required re-operation. Mean follow-up time was 24 months. There were no deaths, but five children developed post-operative complications. Surgical treatment in the form of primary closure of the cyst cavity without drainage seems to offer the best therapeutic option for patients with large hydatid cysts.

An unexpected cause of jaundice

“…Eosinophilia was found in 38% of patients, 3 and the rapid Casoni skin test was found to be positive in between 50% 3 and 83% 4 . The most common serological tests include the complement fixation test, the indirect fluorescent antibody test, ELISA and specific immunoelectrophoretogram.…”

“…Complications of the presence of cysts may include symptoms such as shoulder pain with diaphragmatic irritation, peritonitis, pancreatitis and anaphylaxis with intra‐peritoneal rupture, jaundice and cholangitis with intrahepatic rupture or obstruction, pleural hydatid disease with intrathoracic rupture, or fever and pain with cyst infection and abscess formation. A recent review found that the most common presenting complaint with hydatid disease of the liver is abdominal distension or the finding of an abdominal mass in 15 out of 21 children (71%) 3 . Abdominal pain is often recurrent, or may be acute after blunt trauma.…”

“…Praziquantel is an effective scolicidal agent. It has been recommended as a 1 month pre‐operative treatment 3 . It has been found to be more effective in combination with albendazole than albendazole alone 5,6 .…”

A large cerebral hydatid cyst associated with liver cyst

“…The middle and dogs. 5 Our patient's parents farmed in a rural area of Turkey and she lived in con-layer, the so-called cuticular membrane, is …”

“…8 Cerebral hydatid circulation and involve various abdominal cyst should be kept in mind for the diVerential and extra-abdominal organs. 3,5,6 diagnosis of cystic cranial lesions. In endemic areas, where up to 25% of The hydatid cyst wall has three layers.…”