Hydatid cyst of the liver, a clinical and therapeutic approach on 97 casestreated by surgery.

Objective - The hydatid cyst of the liver; an anthropozoonosis due to a ces tode (Echinococcus granulosus), the usual host of which is the dog, is not common in Western Europe, but has been diagnosed in patients coming from So uthern Europe and Northern Africa. This retrospective study describes the c linical, diagnostic, and therapeutic aspects of the hydatid echinococcosis. Material and methods - We examined the evolution of 97 consecutive patients admitted and treated surgically fora hydatid cyst in 1998 in a Central Tun isia university hospital. Results - The patients' mean age was 41 +/- 19.8 years (range: 4 and 85). T he most common cause for consulting a physician was pain (79.4 %), usually located in the right upper quadrant Sometimes, the disease occurred with th e onset of serious complications. In some cases it was also discovered fort uitously. The most sensitive diagnostic method was abdominal echotomography , positive in every case. Serology and TD scan were also performed in some cases. The treatment was surgery with two methods: a radical and a conserva tive one; 16.5% of postoperative complications are reported for both techni ques (fistula and surinfection). Conclusion - The hydatid disease of the liver is a histologically benign pa thology, but it may become dangerous because of possible serious complicati ons. Although there are efficacious therapeutic weapons, prevention and edu cation of the population living in endemic zones is strongly advised. (C) 2 000 Editions scientifiques et medicales Elsevier SAS.