CLINICAL PROFILE OF PATIENTS WITH HYDATID CYST AND MANAGEMENT AT A TERTIARY CARE CENTER

KAPIL RAMPAL; HARKANWALPREET KAUR; RIPANDEEP SINGH; SUDHIR KHICHY

doi:10.22159/ajpcr.2024v17i8.51530

Authors

KAPIL RAMPAL Department of Surgery, GGSMCH, Faridkot, Punjab, India. https://orcid.org/0000-0003-3533-8805
HARKANWALPREET KAUR Department of Surgery, GGSMCH, Faridkot, Punjab, India.
RIPANDEEP SINGH Department of Surgery, GGSMCH, Faridkot, Punjab, India.
SUDHIR KHICHY Department of Surgery, GGSMCH, Faridkot, Punjab, India.

DOI:

https://doi.org/10.22159/ajpcr.2024v17i8.51530

Keywords:

Hydatid cyst, Echinococcosis, PAIR, Albendazole, Neglected tropical diseases

Abstract

Objective: In this study, we aimed to assess the clinical profile of patients presenting to our surgical unit in the past 5 years, determined the risk factors associated with the disease, and also reviewed the management options.

Methods: It is a retrospective observational study in which case records, from November 2017 to February 2024, were observed for age, gender, occupation, socioeconomic status, clinical features, radiological findings (size, site, number, status, and stage), serological test (enzyme-linked immunosorbent assay), mode of intervention, and a result of the intervention (complications – cysto-biliary fistula, allergic reaction, wound complications, duration of hospitalization, and death).

Results: Of 33 patients studied, 42.42% of cases were from 31 to 40-year-old age group. 57.57% of cases were males. 60.6% of patients were from lower socioeconomic status. Pain abdomen was the most common symptom (84.8%) observed. Organomegaly was the most common (63.6%) sign recorded. Isolated splenic involvement was observed in 6% of cases. 51.6% of the liver hydatid cysts involved the right lobe of the liver and 12.9% had bilobar involvement. Eosinophilia was observed in 15.2% of cases. Raised alkaline phosphatase (63.63%) was the most common liver function test to be deranged. 75.8% of cases were managed with surgery.

Conclusion: Hydatid disease is a neglected tropical disease and continues to be a significant public health matter in tropical and developing countries. A higher general awareness and education about the disease are vital to limit significant associated morbidity and mortality.

Downloads

Download data is not yet available.

References

Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114:1-16.

Shaw JM, Bornman PC, Krige JE. Hydatid disease of the liver. S Afr J Surg. 2006 May;44(2):70-2, 74-7. PMID: 16878513

Ahmed H, Ali S, Afzal MS, Khan AA, Raza H, Shah ZH, et al. Why more research needs to be done on echinococcosis in Pakistan. Infect Dis Poverty. 2017;6:90.

Gadahi JA, Bhutto B, Arlio AG, Akhter N. Human hydatidosis in Hyderabad, Sindh-Pakistan. Adv Trop Med Pub Health Int. 2011;1: 90-4.

Torgerson PR, Devleesschauwer B, Praet N, Speybroeck N, Willingham AL, Kasuga F, et al. World Health Organization estimates of the global and regional disease burden of 11 foodborne parasitic diseases, 2010: A data synthesis. PLoS Med. 2015;12(12):e1001920.

Jarnagin WR. Blumgarts Surgery of Liver, Pancreas and Biliary Tract. 6th ed. Netherlands: Elsevier; 2016.

McManus DP, Gray DJ, Zhang W, Yang Y. Diagnosis, treatment, and management of echinococcosis. BMJ. 2012 Jun 11;344:e3866. doi: 10.1136/bmj.e3866, PMID: 22689886

Fethi D, Mohamed BM, Mehdi BH, Jaafar M, Sabri Y, Ali BA, et al. Hydatid cysts of the liver - diagnosis, complications and treatment. In: Abdominal Surgery; 2012 Aug 14. London: Intechopen. doi: 10.5772/48433

WHO Informal Working Group. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings, Acta Trop. 2003;85:253-61.

Zhang W, Li J, McManus DP. Concepts in immunology and diagnosis of hydatid disease. Clin Microbiol Rev. 2003 Jan;16(1):18-36. doi: 10.1128/CMR.16.1.18-36.2003, PMID: 12525423

Agudelo Higuita NI, Brunetti E, McCloskey C. Cystic echinococcosis. J Clin Microbiol. 2016 Mar;54(3):518-23. doi: 10.1128/JCM.02420-15

Roat R, Yadav S, Damor K, Damor M, Baghel AS. Socio-demographics and clinical profile of hydatid disease: A study in tertiary care hospital Rajasthan. Eur J Mol Clin Med. 2023;10(3):330-6.

Rampal K, Prajapati DK, Sharma M. Hydatid disease - a clinical perspective with a review of primary hydatidosis of spleen. Int J Intger Med Sci. 2016;3(7):337-40. doi: 10.16965/ijims.2016.134

Butt A, Khan JA. Cystic echinococcosis: A 10-year experience from a middle-income country. Trop Doct. 2020 Apr;50(2):117-21. doi: 10.1177/0049475519891338, PMID: 31805832

Fatimi SH, Naureen S, Moizuddin SS, Puri MM, Yousuf MA, Javed MA, et al. Pulmonary hydatidosis: Clinical profile and follow up from an endemic region. ANZ J Surg. 2007 Sep;77(9):749-51. doi: 10.1111/j.1445-2197.2007.04216.x, PMID: 17685951

Kayal A, Hussain A. A comprehensive prospective clinical study of hydatid disease. ISRN Gastroenterol. 2014;2014:514757.

Joshi U, Subedi R, Jayswal A, Agrawal V. Clinical characteristics and management of the hydatid cyst of the liver: A study from a tertiary care center in Nepal. J Parasitol Res. 2020;2020:8867744.

Christodoulidis G, Samara AA, Diamantis A, Floros T, Sgantzou IK, Karakantas KS, et al. Reaching the challenging diagnosis of complicated liver hydatid disease: A single institution’s experience from an endemic area. Medicina (Kaunas). 2021;57:1210.

Marwah S, Kamal H, Marwah N. Laparoscopic management of a large primary retroperitoneal hydatid cyst. Clin J Gastroenterol. 2010;3(5):230-2.