[108 cases of hepatic hydatid cyst]

Area of Science:

• Medical Parasitology
• Hepatology
• Diagnostic Imaging

Background:

• Hepatic hydatidosis, caused by Echinococcus granulosus, presents a significant public health challenge in endemic regions.
• Early and accurate diagnosis is crucial for effective management and prevention of complications.

Observation:

• A 12-year study of 108 hepatic hydatidosis cases in Romania revealed a predominant female demographic (66.11%) with a mean age of 42.88 years.
• The Danube region of Romania is identified as an endemic area for Echinococcus infection, with domestic dogs and cats as primary transmission sources.
• Late diagnosis was frequent, characterized by hepatomegaly and delayed patient presentation, often due to non-specific symptoms like right hypochondrial pain.

Findings:

• Diagnostic imaging sensitivity varied, with ultrasound (echography) at 98% and CT scanning at 100%, while serological tests like hemagglutination inhibition (65%) and counter-immunoelectrophoresis (86%) showed lower sensitivity.
• Unilocular cysts predominated (74.07%), primarily in the right lobe (67.5%), with a mean cyst diameter of over 10 cm at diagnosis.
• Complications occurred in 14.83% of cases, most commonly suppuration (10.19%), and a fatal outcome was recorded due to cyst rupture.

Implications:

• The study underscores the need for enhanced diagnostic strategies in endemic areas, advocating for systematic application of high-sensitivity imaging like echography.
• Improving the accessibility and sensitivity of immunologic tests for ambulatory settings is critical for earlier detection of hepatic hydatidosis.
• Public health initiatives focusing on Echinococcus prevention, particularly regarding domestic animal hygiene and public awareness, are essential in Romania's Danube region.