B Frider1, E Larrieu, M Odriozola. 1. Division of Internal Medicine, Hepatology Unit, Argerich County Hospital, Associated to the University of Buenos Aires, Argentina. frider@bigfoot.com
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.
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.
Authors: Elisabeth Fabian; Christian Madl; Sabine Horn; Peter Kornprat; Ralph Maderthaner; Ariane Aigelsreiter; Robert Krause; Peter Fickert; Guenter J Krejs Journal: Wien Klin Wochenschr Date: 2014-12-04 Impact factor: 1.704
Authors: Nadia Solomon; Paul J Fields; Francesca Tamarozzi; Enrico Brunetti; Calum N L Macpherson Journal: Am J Trop Med Hyg Date: 2017-04-06 Impact factor: 2.345