[Costo-vertebral collection complicating multifocal echinococcosis: surgical drainage via an anterior approach]

Costo-vertebral echinoccoccus is a rare and serious condition which often presents with neurological complications requiring urgent surgical intervention.

We report the case of a seven year old girl admitted with a clinical picture suggesting medullary compression secondary to multifocal Hydatid disease. As well as a costo-vertebral cyst with extension into the spinal canal, lesions were also seen in the lower lobe of her right lung and throughout the liver, confirmed by CT scan and by magnetic resonance imaging. A resection of Hydatid material as well as the posterior part of the 4th rib, the transverse process of the 4th costal vertebra and adjacent bone was carried out via a posterolateral thoracotomy. The cyst in the right lung was successfully excised at the same operation. Three months later six hepatic lesions were removed via a subcostal approach again without complication. A scan 23 months later revealed no evidence of residual hydatid disease.

This case illustrates the pathophysiological features of costovertebral Hydatid disease and the advantages of an anterior surgical approach.