[Renal Hydatid cyst: report on 31 cases]

ABSTRACT

To present recent diagnostic and therapeutic aspects of the renal hydatid cyst. Thirty-one consecutive cases of renal hydatid cyst were seen between January 1989 and June 2006. The patient group consisted of 13 males and 18 females with a mean age of 43 years. The clinical symptoms, biological and radiological investigations as well as the treatment were evaluated. Clinical and radiological examination was diagnostic of renal hydatid cyst in 80.6% of the cases, when combined with serological tests for hydatidosis in 90% of the cases. CT scan confirmed the diagnosis in cases where the radiological examination was not conclusive [4 cases of type IV and 2 cases of type I]. Thirty patients were treated surgically. Percutaneous puncture was done in one case of type I. Twenty-eight patients [90.3%] were subjected to extraperitoneal lombotomy. The anterior approach was chosen in 2 patients due to associated hepatic involvement. The surgical methods consisted of partial cystopericystectomy in 27 [87.1%] patients, pericystectomy in one and nephrectomy in two patients. The immediate postoperative period was uneventful in all but one patient who developed acute pyelonephritis due to the migration of hydatic vesicles into the ureter. The problem resolved after administration of antibiotics and placement of a double-J catheter. Mean follow up was 68 months. During the long-term follow-up based on clinical and radiological examination no recurrence was detected. Radiological and serological examination is the most important step in the diagnosis of renal hydatid cyst. Surgery is the treatment of choice. Percutaneous puncture has recently been used with promising results: