[Personal experience in the diagnosis and treatment of hepatic echinococcosis]

Human echinococcosis is endemic disease that occurs in some regions of Yugoslavia. It is caused by tapeworm Echinococcus granulosus, whose larva can develop cysts in liver and other organs. In the study were presented 119 patients with hepatic echinococcosis, 57 (47.9%) females of average age 41.4 years (9-80) and 62 (52.1%) males of average age 35.5 years (6.72). Primary echinococcosis was present in 75 (63%), and recurrent in 44 (37%) patients. Right lobe of liver was affected in 83 (69.7%), left in 17 (14.3%) and both lobes in 19 (16%) of cases. The complications of hepatic echinococcosis such as cyst infection, cholestasis, cyst rupture in biliary tract and liver fibrosis were observed in 20 (16.8%) patients. Indirect immunofluorescence antibody test was positive in 91 out of 119 (68.1%) patients, and hemagglutination inhibition test was positive in 56 out of 77 (72.7%) patients. Surgically were treated 57 (47.9%) patients, and 41 of them received antihelminithic drugs pre and/or postoperatively. Disease recurrence was observed in 4 (7%) patients. Percutaneous puncture and drainage of echinococcus cyst with simultaneous albendazole administration was performed in 12 (10%) patients. In three of them liver abscess was developed during drainage, and for that reason, two patients had to be surgically treated. Ten (83.3%) patients were completely cured. Medicamentous therapy as the only treatment was used in 31 (26.1%) patients, 9 patients received mebendazole, 19 received albendazole and 3 patients received praziquantel. The success was achieved in 10 (32.3%) patients. Out of the total number, 19 (16%) patients were not treated at all. Surgical removal of the cyst takes a leading place in the treatment of hepatic echinococcosis. However, in well-selected cases and in the patients with high surgical risk, antihelminithic therapy and percutaneous drainage of echinococcus cyst are of more significance.