Echinococcosis (Hydatid disease): lessons from experience with 59 patients.

The records of 59 patients with echinococcal hydatid disease were reviewed. Ultrasonic and computed tomographic imaging were found to be the most reliable diagnostic procedures. Thirty-seven patients with large symptomatic cysts underwent surgery. Most often, conservative extraction of the inner embryonic membranes proved effective, but cysts not extensively involving vital structures were totally excised. Cetrimide became the local scolecidal agent of choice; a role for albendazole in systemic chemotherapy is anticipated. Elective surgery in 30 patients was safe, but urgent surgery in seven patients with acute complications from cyst rupture was followed by substantial morbidity and mortality.