Hydatidosis and Duodenum: A Systematic Review of the Literature

Abstract

Introduction: The duodenum is exceptionally affected by hydatid cyst, either primarily or secondarily (compression or fistulization from hydatid cyst located in neighboring organs). Our aim is to perform a systematic review on fistulization of hydatid cysts to the duodenum. Methods: Following PRISMA guidelines, an unlimited search on duodenal affected hydatid cyst was performed in PubMed, SCielo and EMBASE databases with no limits. Results: Fourteen papers were found, all case reports, which recorded seven men and seven women, with a mean age of 53.14 years. Three patients had recurrent hydatid cyst. The most frequent clinical manifestations were abdominal pain, and nausea and/or vomiting. In almost all cases several imaging studies were performed, but abdominal CT scan was the most used (10/14) (71%). Twelve patients had a fistula between the hydatid cyst and the duodenum, one patient had incidental paraduodenal hydatid cyst and another had severe duodenal compression from liver hydatid cyst without a fistula. Surgical treatment was performed in 12 patients; different surgical techniques were recorded in the different cases (9 conservative surgery versus 3 total cystectomy). Post-operative morbimortality is scarcely described and only one dead and 3 uneventful postoperative were reported. The follow-up period and recurrences could not be determined. Conclusions: The most common symptoms were abdominal pain, nausea and vomiting; CT scan was the most used imaging technique; and hydatid cyst drainage and fistula closure was the most appropriate treatment. All diagnostic and therapeutic options for hydatid cyst that fistulize the duodenum have a low level of evidence.