Diagnosis and treatment of liver hydatid disease.

BACKGROUND/AIMS: Human echinococcosis is endemic in some areas of the world, including Mediterranean countries. The liver is the most frequent seat of echinococcosis, involved in about 70% of cases. Because there is still no effective medical therapy, surgery remains the treatment of choice. METHODOLOGY: Twenty-seven patients operated on for liver hydatid disease between 1990 and 1995 were analyzed and compared with results obtained from a study undertaken at our clinic between 1960 and 1988. RESULTS: The diagnosis was established by typical case history, clinical features and laboratory tests, of which imaging methods proved most informative. Radical procedures (total pericystectomy and liver resection) seem to be too aggressive for treatment. Marsupialization and drainage were mostly abandoned, because of high morbidity rates. CONCLUSIONS: Among surgical procedures used at our clinic, evacuation of the cyst with partial excision of the pericyst and omentoplasty resulted in the lowest morbidity and, thereupon, the shortest post-operative hospital stay and the best clinical results.

[Adenocarcinoma of the colon in a 14-year-old boy]. / Adenokarcinom debelog crijeva u 14-godisnjeg djecaka.

We report the case of a 14-year-old boy with adenocarcinoma of the colon. The diagnosis was established 3 months following the initial symptoms. The tumor was located in the region of the descending colon and was of Dukes B stage. The patient underwent left hemicoloctomy followed by chemotherapy and irradiation. In the follow-up period of two years the patient has been well. It is concluded that early diagnosis, adequate monitoring of patients by the determination of carcinoembryonic antigen and regular follow-up visits could lead to better prognosis.