Elsevier

Journal of Hepatology

Volume 30, Issue 2, February 1999, Pages 228-231
Journal of Hepatology

Long-term outcome of asymptomatic liver hydatidosis

https://doi.org/10.1016/S0168-8278(99)80066-XGet rights and content

Abstract

Background/Aims: The aim of this study was to determine the outcome of asymptomatic liver hydatid cysts in a cohort of 33 out of 59 carriers by evaluating clinical and ultrasonographic (US) changes 10–12 years after initial diagnosis.

Methods: We compared US features and cyst size with the original descriptions from 1984–1986. Patients were questioned about hydatid-related symptoms and signs.

Results: Thirty-three of the 59 carriers could be reevaluated, five (15.2%) of whom had undergone surgery without presenting symptoms, while of 28 unoperated cases, 21 (75%) remained asymptomatic. Of the unoperated cases evaluated by US, in 8/14 (57.1%) there were no modifications in cyst size during the 10-12-year period, in five (35.7%) growth was slight (<3 cm) and in one (7.1%) the cyst grew 4 cm. Mean cyst growth in all 14 cases was 0.7 cm.

Conclusions: Despite the limited number of cases, our results show that most asymptomatic liver hydatid cases (75%) remain symptom-free for more than 10 years, regardless of cyst size or type. We believe that such carriers are at low risk of developing complications, so that it is difficult to establish specific rules for their therapy, if any. Longitudinal follow-up of larger series of asymptomatic hepatic hydatidosis cases is essential to gain a deeper insight into the natural history of such patients, and to draw up comprehensive guidelines for treatment.

Section snippets

Population and Methods

Rio Negro province is situated at the northern border of Argentinian Patagonia, with an area of 203 013 km2 and a total population of 500 695 inhabitants, 20% of whom live in rural areas. In June 1984 and in November 1986, 1018 inhabitants of three rural towns in Rio Negro province (Ñorquinco, Comallo and Pilcaniyeu), located in an arid, semi-desert region of mountains and steppes, were invited to undergo an US and serological screening to detect abdominal localization of hydatid cysts. Lesions

Results

Of the 59 asymptomatic hydatid liver cyst carriers detected during the 1984–86 survey, 35 (59%) were men and the median age of the population was 32.7±10.2 years; three (5.1%) had died from non-hydatid-related causes, 11 (18.6%) had left the geographic area and could not be located, and 45 (76.3%) remained in their original residences (Fig. 1).

Twelve (26.76%) of the 45 available inhabitants could not be controlled as at the time of the study they were in rural areas which were difficult to

Discussion

Given the sparse population in the studied area, only slightly over half of the original 59 patients detected could be re-evaluated 10–12 years later. Despite the limited number of cases, the results of this study show that most untreated cases (75%) remain symptom-free for more than 10 years after diagnosis and, in over half, cyst size is unchanged. These findings support our previous investigations, employing US for mass screening, which disclosed an unexpectedly high prevalence of

Acknowledgements

We thank ADM S.A. for providing the US portable device and the videoprinter system.

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