Percutaneous treatment of hydatid cysts under sonographic guidance

Nine patients (five males, four females) with 14 hydatid cysts were treated with albendazole and percutaneous drainage under sonographic guidance. All but two cysts were hepatic. The average cyst diameter was 81.5 mm (range: 42-180 mm). There were eight type 1 cysts, two type 2, three type 3, and a single type 4. Type 1 and 2 cysts were treated by needle aspiration, type 3 and 4 by needle decompression and catheter drainage. The residual cavity was irrigated with 30% hypertonic saline and injected with absolute alcohol. Biliary fistulization contraindicated alcohol use. All cysts were successfully treated. A single episode of reversible anaphylaxis was encountered. Serial sonographic examinations revealed residual cavities ranging from 10 to 35 mm in diameter. No new cysts were noted during an average follow-up of 9.6 months. The mean hospital stay was 48 hr. Percutaneous drainage of hydatid cysts is a relatively safe and cost-effective procedure.