Hydatid Disease In Children Research Articles

Clinical Pattern of Pediatric Hydatid Disease.

Literature regarding hydatid disease in children is sparse. To highlight the peculiarities in the clinical pattern of pediatric hydatid disease (PHD). Data were collected retrospectively from all children aged <18 years who presented to our tertiary care institute from July 2021 to June 2023 with hydatid disease involving any organ. Simple statistical analysis involving sums, means, averages, and percentages. Four of the 10 cases (40%) involved the lung, while only 2 (20%) involved the liver. There were five females and four males with an age range of 2-17 years. Four of the cases had primary extrahepatic extrapulmonary hydatid disease (40%), two involving the pancreas, one in the rectouterine pouch, and one intracranial. The clinical pattern of PHD is different from that of adults. Pulmonary echinococcosis is more common than hepatic involvement. Primary extrahepatic extrapulmonary hydatid disease is also more common in children than previously thought. A cystic lesion anywhere in a child warrants a differential of hydatid disease.

Cystic Hydatid Disease in Children in Gorgan from 2014 to 2021

Background: Cystic hydatid disease is a serious human cestode infection caused by the larval stage of Echinococcus granulosus. Hydatidosis is an important health and economic problem in Iran. Objectives: This study aims to investigate clinical manifestations, laboratory findings, and imaging of hydatidosis in children. Methods: This cross-sectional descriptive study was conducted based on the information recorded in the files of patients hospitalized due to hydatidosis at the Taleghani Children's Hospital in Gorgan from 2014 to 2021. The data was analyzed with the help of SPSS software version 25, utilizing descriptive statistics and the chi-square test. Results: Out of 58,974 patients admitted to Taleghani Hospital during 2014 - 2021, the frequency of hydatidosis was 42 (0.071%) cases. The patients comprised 78.5% boys and 21.5% girls, with an average age of 8.5 years ranging from 3 to 17 years old. A significant statistical difference was seen between the sexes (P = 0.012). There was a history of close contact with animals in 76.2% of patients and 73.9% of children in the village. The frequency of the total cyst was 75, and the most common location of the cyst was in the liver (60%) in the right lobe of the liver (54.6%) and then in the lung (36%) in the RLL region (17.4%). Single cysts (57.1%), unifocal cysts (61.9%), and CE1 cysts (40%) had the highest frequency. The most common symptom of liver involvement was abdominal pain (59.5%) and chronic cough in lung cysts (45.2%). Cysts with a size of 5 - 10 cm had the highest frequency (52%), and most were hypoechoic (48%). Positive serology test was reported in 11 cases (26.2%) and positive pathology in 22 cases (52.4%). The chance of hydatidosis in boys was 2.5 times higher than in girls, and in rural areas, it was more than three times higher than in urban areas. Conclusions: In this study, hydatidosis was more common in village boys aged 3-9. The liver and lung involvement were common, which required surgery in most cases. Considering the high prevalence of this disease in Gorgan, it is necessary to design an intervention plan to reduce children's burden, and a multidisciplinary approach should be planned to reduce its mortality and morbidity among children.

Outcome of the Treatment of Hydatid Disease in Children over a Period of 8 Years

Outcome of the Treatment of Hydatid Disease in Children over a Period of 8 Years

Hydatid Disease in Children from Diagnosis to Treatment: A 10-year Single Center Experience

Hydatid disease caused by Echinococcus granulosus is a parasitic zoonosis and is endemic in Turkey. Clinical manifestations vary and are related to the anatomical location. In this report, we shared the diagnosis, treatment and follow-up of hydatid disease in children with a 10-year experience. A total of fifty-seven children diagnosed with hydatid disease were analyzed retrospectively from hospital records. Diagnosis was based on clinical, serological and radiological findings. Treatment response was evaluated with clinical, radiological and serological findings. The male/female ratio of 57 cases was 2.4:1 and the mean age was 113.6±45.9 months. The most common presenting complaint was abdominal pain (42.1%). While 22 (38.6%) of the cases had eosinophilia; indirect hemagglutination test positivity was detected in 27 cases (47.4%). Multiple organ involvement was present in 18 cases (31.6%). In patients with multiple organ involvement, the possibility of cysts being located in the abdomen was higher (p=0.005). Of the 50 cases (87.7%), 45 (78.9%) were operated with open surgery and 5 (8.8%) with percutaneous aspiration-injection-reaspiration method for treatment. There were 52 (91.2%) patients who were given albendazole in conservative treatment and the mean duration of treatment was 15.5±17.2 months. There were 10 cases (17.5%) who developed cyst rupture and the symptom duration was shorter than the cases without cyst rupture (p=0.017). Cyst rupture was more common in cases with dyspnea and fluid discharge from the mouth called rock water (p=0.001, p=0.005, respectively). Recurrence was observed in five cases (8.8%) during follow-up. In areas where the disease is endemic, despite prevention and control programs consisting of personal habits and health education, active transmission of hydatid disease is seen in children and continues to be an important public health problem. Hydatid disease should definitely be considered in the presence of suspicious radiological and clinical findings in endemic areas. Controlled clinical studies are required for diagnosis and treatment procedures.

Comparison of laparoscopic and open surgery in hepatic hydatid disease in children: Feasibility, efficacy and safety.

Background:Surgery continues to be the mainstay of treatment of hydatid cysts of the liver. Laparoscopy provides a lesser invasive tool for achieving results same as with the established open surgical techniques. The purpose of the study was to evaluate the feasibility and safety of laparoscopic management of hepatic hydatid disease in children.Patients and Methods:It was a prospective randomised study conducted over a period of 7 years. Children with Gharbi Type I, II, III cysts, ≤3 cysts and superficial accessible cysts were treated laparoscopically and their outcomes were compared with matched controls treated by open approach.Results:Sixty patients were included in the study with thirty patients in each matched group. Thirty paediatric patients (male 12:female 18) with 35 liver hydatid cysts underwent laparoscopic surgery. The mean cyst size was 8.8 ± 2.39 cm. Two patients needed conversion to open. No significant spillage of cyst contents was observed in any of the patients. Duration of hospital stay, time to removal of drains, duration of parenteral analgesia, severity of pain in postoperative period, time to ambulation and time to return to full orals were significantly lower in laparoscopic group compared to open group. Complication rates in both the groups were similar.Conclusion:With proper patient selection, laparoscopic management of hydatid cysts of the liver in children is feasible and safe option with low morbidity, low rates of conversion and minimal complications.

PREDICTORS OF CYSTOBILIARY COMMUNICATION IN HYDATID DISEASE OF LIVER, INTRA-OPERATIVE AND POST OPERATIVE MANAGEMENT IN CHILDREN AT A SINGLE INSTITUTION IN NORTHERN INDIA.

Introduction: Hydatid disease in children is highly prevalent in this part of world due to lack of proper hygiene. Cystobiliary communication(CBC) with hepatic hydatid disease is responsible for postoperative bile leakage and morbidity . Aims: Our study aimed to predict the communication, intraoperatively diagnose it and manage it postoperatively in case not diagnosed previously. Material and Methods:This is a prospective , cohort study of all children with hydatid disease of the liver.Patient data were recorded on an internal web-based registry system supplemented by paper records. All the patients who underwent surgery for hydatid disease from 2013 to 2019 were assessed for presence of CBC and only patients with CBC were included in the study and studied. Results: A total of 97 patients presented with hydatid disease of liver during the said period.There were a toatal of 20 (20.6%) CBC among these .Males had more CBC than females (m:f=2:1). Conclusion: Cyst size &gt;10cms,jaundice, right lobe cyst preoperatively were the most important predictors of CBC.It was found that on-table suturing of CBC with deposition of pedicled omentum was the most effective way of preventing post-operative bile-leak. Management depends on the size of the fistula, the site of the cyst, and the experience of the hepatobiliary surgeon.

Hydatid Disease in Children, Our Experience at Queen Rania Al Abdullah Hospital

Background: Hydatid disease in children is one of the commonest proplems in pediatric age group in Jordan. It is complications is the main concern of pediatric surgeons in Queen Rania Alabdullah Hospital for children. Objective: The aim of our research is to represent our experience in dealing and management of children with hydatid disease in Queen Rania Al Abdullah Hospital for children. Materials and methods: Retrospective study was conducted over period from Feb 2011 till Sep 2019, the medical records of 63 patients with hydatid disease who were treated in our centre were collected. Demographic data, site of disease, complications, and outcome were demonstrated and analysed. Results: 63 patients with hydatid disease were seen in our centre since 2011 till 2019. 39 were males and 24 females with male to female ratio (1,6:1) Mean age was 8,5 years, ranged from 2,3 to 14,8. Single organ involvement was seen in 55 patients versus 8 patients with multiple organs. Conclusion: Hydatid disease is a common proplem in our country. Lung involvement is the most common involved organ in pediatric age group. Surgery is the main modality of treatment with high success rate and low complications.

Hepatopulmonary hydatidosis in a 2 year old boy - Thoracoscopy and laparoscopy for management

Hydiatidosis is an endemic pathology in several countries of the world and represents a public health problem. It is a zoonosis caused by cestodes of the genus Echinococcus granulosus. Here, we present a case of a two year old boy with hepatopulmonaryhydatidosis with cysts in left lung and left lobe of liver treated with minimal access surgery. The boy was brought with the complaints of fever, abdominal pain and decreased appetite. There was a history of contact with a pet dog since 6 months. Investigations showed leukocytosis with eosinophilia. Computed tomography showed hepatic and left lung hydatid cysts. Treatment of the case included thoracoscopy and laparoscopy in a single surgery. The patient recovered well after the surgery. Hepatopulmonary hydatidosis is rare in children. Minimal access surgery for the management of hydatid disease is feasible and safe in well selected cases • Hepatopulmonary hydatidosis is a rare in children. • Single surgery for management of multiple site hydatid cysts is effective in decreasing hospital stay and financial burden. • Minimal access surgery is safe and enhances recovery in the treatment of hydatid disease in children.

Surgical management of pulmonary hydatid cysts in children in KwaZulu-Natal Province, South Africa.

Background Pulmonary hydatid cyst disease is still a major problem in countries like South Africa (SA), where livestock farming is common. Hydatidosis has a variable clinical course depending on the size, location and complications of the cyst. For pulmonary cysts of any size, surgery remains the gold standard for treatment, with lung conservation surgery being the ideal. Objectives To describe the epidemiology, clinical presentation, surgical management, and surgical outcomes of paediatric pulmonary hydatid disease in children referred to the Department of Cardiothoracic Surgery at Inkosi Albert Luthuli Central Hospital (IALCH) in KwaZulu-Natal Province, SA. Methods We retrospectively reviewed and analysed the medical records of 38 children between the ages of 0 and 18 years with pulmonary hydatid cysts, who were referred to the Department of Cardiothoracic Surgery at IALCH and underwent surgical management between 1 January 2008 and 31 December 2018. The medical records were evaluated for patients’ demographics, clinical evaluation, surgical management strategies and surgical outcomes. Results Of the 38 patients, 60.5% were male, with a mean age of 6.5 years. More than two-thirds of the patients (68.4%) were from the Eastern Cape and 31.6% were from KwaZulu-Natal. The majority of the cysts (84.2%; n=32) were classified as large (5 - 9 cm in diameter) and giant (≥10 cm in diameter). Forty-eight surgical procedures were performed and lung preservation surgery by enucleation and capitonnage was preferred. Some patients developed postoperative complications such as prolonged air leaks from bronchopleural fistula (18.8%; n=9) and 88.9% (n=8) of these patients healed with chest tube drainage and physiotherapy. Lung resection was only required in 4% (n=2) of the patients. The mean (standard deviation) number of days spent in hospital was 7 (4) days. All children survived with no recurrences. Conclusion Conservative surgical procedures such as enucleation of the cysts of any size are possible, safe, reliable and reproducible.

Hydatid disease in children: a single centre study with analysis of treatment protocol

Background: Hydatid disease or hydatidosis is a zoonosis which is still an important health hazard in the world. This disease is a parasitic infestation which is endemic in many sheep and cattle raising areas of the world including India. The aim of this study was to evaluate the clinical features, diagnosis, and treatment of hydatid cyst in pediatric population.Methods: This prospective study evaluated 32 pediatric patients with hydatid cyst who were treated at Geetanjali Hospital, Udaipur from 2016-2018. Medical records of these patients were studied and analyzed.Results: 32 cases were in the age group of 7 to 14 years and were from rural background/ farming community and of low socioeconomic status. Male children, lungs were predominantly involved. Cattle rearing were common to the households of all patients. Ultrasonography and computed tomography scan were done in all patients and was the main diagnostic modality. All cases were managed surgically along with albendazole therapy and had complete recovery with no recurrence till date in any of our patients.Conclusions: Hydatid disease is not rare in the pediatric age group. The liver and lung are commonly involved, but it may also present as primary disease in unusual sites like the spleen and brain. Careful surgery to avoid spillage with full course of drug therapy with albendazole can ensure permanent cure. A 28 day post-operative course was sufficient in majority of the cases. The disease can be prevented by proper community based measures like availability of clean water, sanitation and drug prophylaxis.

Long-term outcome of minimal access surgery for hydatidosis in children: a single institutional experience

Human cystic echinococcosis continues to be a public health problem worldwide. The standard treatment of hydatidosis in children is open surgical intervention for removal of the cyst completely without spillage. The limited use of minimal invasive surgery (MIS) in hydatidosis has been due to the concern of inadequate removal and spillage, leading to recurrence or dissemination of the disease. Recently, a few authors have reported the successful use of minimal invasive surgery (MIS) for management of hydatid disease in children. We present our experience with successful use of MIS in the management of hydatid disease involving lung and liver in children. Between 2006 and 2017, data of 22 children treated for hydatid disease in our institute were reviewed. The diagnosis was made radiologically with Computerised Tomography scan of chest and abdomen. All children received albendazole therapy prior to and after the surgery. Thoracoscopic/laparoscopic procedures were undertaken sequentially in all children. Children with synchronous disease involving lung and liver had an interval of 2 weeks between procedures. The techniques of puncture, aspiration, injection and re-aspiration (PAIR) and also our modifications of cyst removal are described. There were a total of 22 children with liver and or lung involvement. Four children had synchronous lung and liver involvement and four children had bilateral lung involvement. The duration of the procedure ranged from 60 to 90 min. There were 3 (18) conversions in the thoracic group and 1 (12) in the laparoscopic group. PAIR technique with our modification of cyst extraction was used in all except in one child. Capitonnage of the cyst wall in lung hydatidosis was not done. There were no postoperative events. Recurrence of the lesion at original site was seen in two children, one each in laparoscopic and thoracoscopic group. Occurrence of new lesion or dissemination of the disease was not identified on a mean follow-up of 7 years. Our series demonstrates the safe and effective utility of MIS in management of pulmonary and liver hydatid in children. Use of MIS does not lead to dissemination of the disease. Albendazole therapy is an useful adjunct prior to surgery. Single lung ventilation with isolation of uninvolved lung is useful during surgery for lung hydatid.

Prospective Comparison of MRI and Contrast-Enhanced MDCT for Evaluation of Pediatric Pulmonary Hydatid Disease: Added Diagnostic Value of MRI.

OBJECTIVE. The objective of our study was to prospectively investigate the diagnostic accuracy and added value of fast MRI for evaluating pulmonary hydatid disease in children by comparing fast MRI findings with MDCT findings. SUBJECTS AND METHODS. Twenty-eight consecutive children (24 boys and four girls; mean age ± SD, 8.93 ± 3.1 years; range, 5-17 years) with clinically suspected pulmonary hydatid disease were enrolled in this prospective research study for the period from October 2012 to July 2018. Fast MRI without contrast material and contrast-enhanced MDCT of the chest were performed within 48 hours of each other in all children. Two pediatric radiologists independently evaluated the lungs for the presence of consolidation, nodule, and mass (solid vs cyst). Cysts were further evaluated for the presence of fluid, air, and an internal membrane. The accuracies of fast MRI and MDCT for detecting pulmonary hydatid disease were obtained and compared. Interobserver agreement was measured with the kappa coefficient. RESULTS. The accuracy of fast MRI and MDCT for detecting pulmonary hydatid cyst was 92.86%. There was no difference between fast MRI and MDCT for accurately detecting pulmonary hydatid cyst (p < 0.001). Internal membranes were detected in 11 of 28 patients (39.28%) with fast MRI and three of 28 patients (10.71%) with MDCT. Almost perfect interobserver agreement was present between the two independent reviewers (κ = 1). CONCLUSION. Fast MRI without contrast material is comparable to contrast-enhanced MDCT for accurately detecting lung cysts in pediatric patients with pulmonary hydatid disease. However, fast MRI provides added diagnostic value by showing internal membranes of cysts, which is specific to pulmonary hydatid disease.

Hydatid disease in children of Buenos Aires Province

Hydatidosis is a parasitic zoonosis caused by Echinococcus granulosus. It is endemic in Argentina and in the province of Buenos Aires, especially to the south of the Rio Salado basin. During 2014 and 2016, the Department of Rural Zoonoses was notified of 479 cases of hydatidosis, with 12.1% confirmed in children under 18 years of age. Fifty-nine percent corresponded to males and the group of 13 to 17 years was the most prevalent one (47%). Sixty-four percent had liver involvement, 22% pulmonary involvement, 5% hepatopulmonary involvement, 5% splenic involvement and 4% cerebral involvement. Thirtythree percent of the cases were asymptomatic. Sixty percent resided in urban areas and of these 20% did not present an epidemiological link. This is a disease of mandatory reporting and there are provincial and national programs that contemplate free actions tending to control it, but despite this, it continues to be a difficult problem to solve.

Laparoscopic management of renal and hepatic hydatidosis in a child: a case report and review of literature

Hydatidosis is an endemic disease caused by Echinococcus granulosus. Humans are accidental intermediate hosts. In children, it affects the lung in 64% of cases and the liver in 28%. Renal involvement is uncommon (2-4%). We operated 7 years old girl with renal and hepatic hydatidosis laparoscopically. Hydatid cyst should be kept as one of differential diagnosis while managing cystic disease of any organ in the body. To the best of our knowledge this is the first case of renal hydatidosis with hepatic hydatidosis that has been managed laparoscopically. Laparoscopic surgery is safe and efficacious in managing multiorgan hydatid disease in children.

Epilepsy: Unusual presentation of cerebral hydatid disease in children

Cerebral hydatid disease is very rare, representing only 2% of all cerebral space occupying lesions even in the countries where the disease is endemic. Intracranial hydatid cysts are more common in children and occur more frequently in the supratentorial space. The aim of this paper is to describe the characteristic features of computed tomography (CT) and magnetic resonance imaging (MRI) and to determine the clinical presentation and surgical outcome of cerebral hydatid disease. Medical chart and records were reviewed retrospectively to determine demographic data, clinical findings, morphological assessment, surgical approaches and outcomes. A 7-year-old girl was admitted to the emergency department because of an epileptic attack. On radiological examination, a round, cystic lesion appeared in the parietal lobe and caused shift of the midline structures. The cyst was successfully removed using the Dowling technique. The postoperative period was uneventful and seizures were not seen during follow-up. Hydatid cyst of the brain presents clinically as intracranial space occupying lesion and is more common in children, it is well demonstrated by CT and MR examinations and surgery is the treatment option with affordable morbidity and low mortality.

Hydatid disease in children: Our experience

Summary Background/Introduction Hydatid disease is relatively uncommon in children. The liver and lungs are most commonly involved, while involvement of other sites in the body is unusual. Purpose(s)/Aim(s) To study the presentation of hydatid disease in children, evaluate the risk factors, and derive appropriate management recommendations for prevention of recurrence and disease control. Methods This was a retrospective study performed from April 2006 to April 2014 in three pediatric institutes. Results There were 18 cases of hydatid disease in children; their age ranged from 7 to 16 years, and the male to female ratio was 8:1. All 18 patients were from a rural background or a farming community and of low socioeconomic status. Cattle rearing was common to the households of all patients. Nine (50%) patients had isolated liver hydatid cyst and three (16.7%) had isolated primary lung hydatid cyst. Two (11.1%) patients had multiple cysts with lung and liver involvement, while four (22.2%) had unusual presentation, i.e., primary hydatid cyst of the spleen in three (16.7%) and primary hydatid cyst of the brain in one (5.5%). All cases were managed surgically and there was no recurrence in any of our patients. Conclusion Hydatid disease is not rare in the pediatric age group. The liver and lung are commonly involved, but it may also present as primary disease in unusual sites like the spleen and brain. Proposed risk factors are rural background, farming community, low socioeconomic status, cattle rearing, lack of supply of potable water, and male sex. Intrinsic defects in the filter mechanism of the liver and lungs, dissemination through enteric lymphatic channels, and patency of the ductus arteriosus in early infancy are the proposed causes of unusual presentation of hydatid disease in children. During cyst removal, spillage of the contents must be avoided to prevent recurrence. Community-based measures are recommended for prevention and disease control.

Pulmonary hydatid disease is difficult recognized in children.

Pulmonary hydatid disease is a significant health problem for children in endemic areas. Pulmonary hydatid disease is more frequent than hepatic hydatid disease in children. The aim of this study was to evaluate the characteristics of pulmonary hydatid disease for children in our province which is endemic for echinococcosis. This study was performed retrospectively between 2007 and 2012 by reviewing the medical records of patients (≤17 years) who were diagnosed with pulmonary hydatid disease. The medical records of these patients were evaluated with respect to the demographic characteristics of patients, management strategies, length of hospital stay, and outcomes. A total of 120 (52.9% boys and 46.3% girls) patients with the diagnosis of pulmonary hydatid disease were enrolled in this study. The mean age was 10.15 ± 3.93 years. The significant numbers of patients were admitted with a ruptured hydatid disease and managed with lung preservation. The mean follow-up was 11.3 ± 3.8 (3-24) months. Recurrence was detected in three patients during follow-up. Pulmonary hydatid disease is usually symptomatic. Hydatid disease must be considered in differential diagnosis while evaluating thoracic lesions in endemic areas.

Characteristics and outcomes of liver and lung hydatid disease in children

Our study retrospectively evaluates and compares the characteristics of lung and liver hydatid disease (HD) in children. This retrospective study was performed between 2007 and 2012 using the medical records of patients aged ≤17 years of age who had liver and/or lung HD. They were evaluated using the demographic characteristics of the patients, clinical presentation, hospital stay and outcome. A total of 252 cysts were identified in 152 of the patients. The incidence of HD increased with age and the majority of patients were older than 9 years. Overall, lung HD was more complicated and symptomatic than liver HD on initial admission.

Pulmonary hydatid disease in children: outcome of surgical treatment combined with perioperative albendazole therapy

Pulmonary hydatid disease in children: outcome of surgical treatment combined with perioperative albendazole therapy

Hidatidosis en la infancia: Albendazol en su tratamiento médico y quirúrgico

The aim of this study was to observe the response of hydatid disease in children to albendazole, either combined with or without surgery. The study was performed at Dr. L. Calvo Mackenna Hospital, between 1997 and 2000, in 15 patients. Thirteen patients received post surgery treatment because of daughter cyst finding and 2 received chemotherapy only. Albendazole was given orally (dose: 5 mg/kg bid for a mean time of 25 days) in 1 to 5 courses. Treatment evaluation was based on changes in cyst morphology, sonography and computed tomography, hematological and serological analysis. Seven patients had full response; the other had clinical and serological improvement. According with previously published experience, albendazole was efficient as a paliative pharmacological treatment instead of surgical procedure, in case of non-practicable hydatid cyst surgery. Moreover, albendazole is useful in case of multiple daughter cysts, well tolerated and reduced side effects in the follow-up.