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Liver Hydatid Cyst in Children (A 14-year Review)
Alireza Mirshemirani1, Ahmad Khaleghnejad, Jaefar Kouranloo
1Pediatric Surgery Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Hydatid disease, a parasitic infestation, affects children in endemic regions. Liver sonography is recommended for diagnosis, with surgery as the primary treatment for liver hydatid cysts.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Parasitology
Background:
- Hydatid disease poses a significant global health challenge, particularly in sheep and cattle raising areas like Iran.
- It is a parasitic infestation requiring effective diagnostic and treatment strategies, especially in pediatric populations.
Purpose of the Study:
- To evaluate the clinical presentation, diagnostic methods, and treatment outcomes for liver hydatid cyst in children.
- To assess the efficacy of sonography and surgical interventions in managing pediatric hydatid disease.
Main Methods:
- A retrospective study analyzed 100 pediatric patients (ages 1-14) with liver hydatid cysts treated between 1996 and 2010.
- Data collected included patient demographics, symptoms, diagnostic investigations, surgical techniques, hospital stay, and treatment outcomes.
- Variables like mortality, morbidity, and recurrence rates were evaluated.
Main Results:
- Abdominal sonography achieved a 94% diagnostic accuracy.
- Conservative surgical treatment was performed in 98% of cases, with wound infection being the most common complication (3%).
- The morbidity rate was 12%, with one mortality (1%) and two recurrences (2%).
Conclusions:
- Liver sonography is highly accurate and recommended for diagnosing hydatid cysts in endemic areas due to its minimally invasive nature.
- Surgical intervention remains the preferred treatment modality for liver hydatid cysts in children.
Objective:
Hydatid disease is still an important health hazard in the world. This disease is a parasitic infestation which is endemic in many sheep and cattle raising areas such as in Iran. The aim of this study was to evaluate the clinical appearance, diagnosis, and treatment of liver hydatid cyst in children.
Methods:
This retrospective study evaluated 100 patients who were referred to Mofid Children's Hospital with liver hydatid cyst from March 1996 to March 2010. Medical records of 1 to 14 year old patients who had definitive liver hydatid cyst were included and analysis of variables such as age, gender, symptoms, diagnostic investigation, operative technique, hospital stay, mortality, morbidity and outcome of treatment were evaluated.
Findings:
The patients consisted of 54 boys (54%) and 46 (46%) girls with an age range of 1-14 years (mean 11.8±4.6). The incidence rate increased by age. The patients had totally 110 cysts, right pulmonary lobe 81 (73%) cysts and left side had 29 (27%). Abdominal mass was the most common (50%) symptom. Abdominal sonography gave correct diagnosis in 94 (94%) patients. Conservative surgical treatment was carried out in 98 children. Two patients were treated medically as the cysts were small and calcified. The most common complication was wound infection in 3 cases. Mean length of hospitalization was 9 days. In 100% of our patients the type of parasite was Echinoccocus granulosus. The morbidity rate was 12% (prolonging external catheter drainage in 12 patients). There was only one (1%) mortality and 2 (2%) recurrences.
Conclusion:
Due to the less invasive and high accuracy of liver sonography in diagnosis of hydatid cyst, we recommend it as the method of choice for the diagnosis in endemic regions. Surgery is the method of choice for treatment.
