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Hydatid disease in childhood: a retrospective analysis of 376 cases
1Hacettepe University Faculty of Medicine, Department of Pediatrics, Ankara, Turkey.
Insights
Medical treatment is recommended for childhood hydatidosis, showing lower relapse rates than surgery. Surgical intervention is reserved for complicated cases involving infection or organ obstruction.
Area of Science:
- Pediatrics
- Infectious Diseases
- Parasitology
Background:
- Hydatid disease, caused by Echinococcus granulosus, affects children worldwide.
- This study reviews a large cohort of pediatric hydatidosis cases over two decades.
Purpose of the Study:
- To evaluate the efficacy of different treatment modalities for childhood hydatidosis.
- To compare relapse rates between medical and surgical interventions.
Main Methods:
- Retrospective analysis of 376 children treated for hydatid disease.
- Categorization of treatments into medical, surgical, combined, and percutaneous drainage.
- Assessment of treatment outcomes and relapse rates.
Main Results:
- The lungs (222) and liver (56) were the most common sites of hydatid cysts.
- Medical treatment demonstrated a lower relapse rate compared to surgical treatment.
- Complications like infection and organ obstruction necessitated surgical intervention.
Conclusions:
- Medical management is the preferred initial therapy for uncomplicated pediatric hydatidosis.
- Surgery is indicated for complicated cases, including infection or obstruction of vital structures.
- Optimizing treatment strategies can reduce relapse rates in childhood hydatidosis.
Abstract:
During a 20-year period, 376 children with hydatid disease were treated at Hacettepe University Ihsan Doğramaci Children's Hospital. There were 223 males and 153 females with a mean age of 8.9+/-0.1 years. Hydatid cysts were localized in the lungs in 222 patients, in the liver in 56 patients, and in other organs in the remaining patients. Cough, fever, and abdominal pain were the most common symptoms. One hundred eight patients had medical, 182 patients had surgical, 73 patients had medical and surgical, and 4 patients had medical and percutaneous drainage treatment as the initial therapy. When evaluating the results of therapy, the relapse rate was higher in surgically treated patients than medically treated patients. We conclude that medical treatment of childhood hydatidosis is best, except in cases with complications such as infection, parenchymal compression or obstruction of airways, bile duct or viscera; all of these are indications for surgical therapy.