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Hydatid disease in childhood
Fehmi Celebi1, Ahmet A Balik, A Bedii Salman
1Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey. fcelebi@atauni.edu.tr
Insights
Surgery remains a key treatment for pediatric liver hydatid disease (HDL). Omentoplasty and capitonnage are most effective for managing the cyst cavity, with lower complication rates than other methods.
Area of Science:
- Pediatric Surgery
- Hepatology
- Parasitology
Background:
- Hydatid disease of the liver (HDL) is a parasitic infection caused by Echinococcus tapeworms.
- Pediatric involvement requires specific surgical considerations due to anatomical differences and potential for growth disturbances.
Purpose of the Study:
- To review and compare the outcomes of various surgical treatment modalities for pediatric liver hydatid disease.
- To identify the most effective surgical techniques for managing the cyst cavity in children.
Main Methods:
- Retrospective review of 31 pediatric patients treated surgically for HDL between 1990 and 2000.
- Surgical procedures included unroofing plus tube drainage (UTD), capitonnage, omentoplasty, and pericystectomy.
- Analysis of complications such as cholangitis and biliary fistula associated with each modality.
Main Results:
- The most frequent symptoms were abdominal mass and right-upper-quadrant pain.
- Cysts were predominantly located in the right lobe of the liver; 8 patients had multiple hepatic cysts, and 5 had cysts in other organs.
- Unroofing plus tube drainage (UTD) resulted in 2 cases of cholangitis and 1 biliary fistula. Capitonnage led to 1 case of cholangitis.
Conclusions:
- Surgery remains a primary treatment modality for pediatric liver hydatid disease.
- Omentoplasty and capitonnage demonstrated the highest efficacy in managing the cyst cavity, suggesting they are preferred techniques.
Abstract:
To review the results of different modalities of treatment of hydatid disease of the liver (HDL) in pediatric patients, 31 children treated surgically between 1990 and 2000 at the departments of general surgery and pediatric surgery, Atatürk University School of Medicine, were reviewed retrospectively; 19 were male and 12 were female. The mean age was 8.4 years (range 4-12 years). The most common complaints were an abdominal mass and right-upper-quadrant pain, which were present in 35.5% and 77.4% of cases, respectively. Twenty-five cysts were in the right lobe, 2 in the left lobe, and 4 in both lobes; 8 patients had multiple hepatic cysts and 5 had coexisting cysts in other organs. Surgical procedures were: unroofing plus tube drainage (UTD); capitonnage; omentoplasty; and pericystectomy. Of the patients treated by UTD, 2 developed cholangitis and 1 developed a biliary fistula. Of the patients with capitonnage, 1 developed cholangitis. Surgery is still one of treatment modalities for management of HDL. Omentoplasty and capitonnage are the most effective modalities for the management of the cyst cavity.