Reaching the Challenging Diagnosis of Complicated Liver Hydatid Disease: A Single Institution’s Experience from an Endemic Area

<i>Background and Objectives:</i> Hydatid disease (HD) remains a significant public health issue causing morbidity and mortality in many Mediterranean countries. <i>Material and Methods:</i> The present cohort study included 50 consecutive patients with liver hydatid disease...

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Autores principales:	Gregory Christodoulidis, Athina A. Samara, Alexandros Diamantis, Theodoros Floros, Ioanna-Konstantina Sgantzou, Kostas-Sotirios Karakantas, Prokopis-Andreas Zotos, Antonios Koutras, Michel B. Janho, Konstantinos Tepetes
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	<i>Echinococcus</i> liver complications endemic hydatid disease Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/9ede1b3902fe437bbb281d54a4f74dfc
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spelling	oai:doaj.org-article:9ede1b3902fe437bbb281d54a4f74dfc2021-11-25T18:18:36ZReaching the Challenging Diagnosis of Complicated Liver Hydatid Disease: A Single Institution’s Experience from an Endemic Area10.3390/medicina571112101648-91441010-660Xhttps://doaj.org/article/9ede1b3902fe437bbb281d54a4f74dfc2021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1210https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background and Objectives:</i> Hydatid disease (HD) remains a significant public health issue causing morbidity and mortality in many Mediterranean countries. <i>Material and Methods:</i> The present cohort study included 50 consecutive patients with liver hydatid disease who underwent surgery in a tertiary University Hospital. A total of 18 patients (36%) had a case of complicated HD, including simple communication of the cyst with the biliary tree (6 cases), rupture of the cyst into the biliary tree (6 cases), presence of a bronco-biliary fistula (2 cases), rupture of the cyst in the peritoneal cavity (2 cases), and rupture of the cyst and formation of a hepatic abscess (2 cases). Endoscopic retrograde cholangiopancreatography (ERCP) was pre-operatively performed on six patients. <i>Results:</i> The main clinical symptom presented was right upper quadrant pain in 16 patients (88%), which was associated with high fever (>39 °C) in 14 patients (78%). C-reactive protein (CRP) was the primary indicator of a complicated HD (<i>p</i> = 0.003); however, it was only elevated in 67% of cases. CRP was a more sensitive indicator of a rupture in the biliary tree cyst (<i>p</i> = 0.02). Computer tomography (CT) detected more cases (44%) of a complicated HD than ultrasonography (US) (25%); however, the difference was not statistically significant. <i>Conclusions:</i> For prevention and control of HD, a high suspicion of the disease leading to early referral to specialized centers, mainly in endemic areas, is required. Prior to surgical or percutaneous intervention, a combination of imaging and laboratory findings are essential in diagnosing a complicated case and avoiding unnecessary interventions.Gregory ChristodoulidisAthina A. SamaraAlexandros DiamantisTheodoros FlorosIoanna-Konstantina SgantzouKostas-Sotirios KarakantasProkopis-Andreas ZotosAntonios KoutrasMichel B. JanhoKonstantinos TepetesMDPI AGarticle<i>Echinococcus</i>livercomplicationsendemichydatid diseaseMedicine (General)R5-920ENMedicina, Vol 57, Iss 1210, p 1210 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	<i>Echinococcus</i> liver complications endemic hydatid disease Medicine (General) R5-920
spellingShingle	<i>Echinococcus</i> liver complications endemic hydatid disease Medicine (General) R5-920 Gregory Christodoulidis Athina A. Samara Alexandros Diamantis Theodoros Floros Ioanna-Konstantina Sgantzou Kostas-Sotirios Karakantas Prokopis-Andreas Zotos Antonios Koutras Michel B. Janho Konstantinos Tepetes Reaching the Challenging Diagnosis of Complicated Liver Hydatid Disease: A Single Institution’s Experience from an Endemic Area
description	<i>Background and Objectives:</i> Hydatid disease (HD) remains a significant public health issue causing morbidity and mortality in many Mediterranean countries. <i>Material and Methods:</i> The present cohort study included 50 consecutive patients with liver hydatid disease who underwent surgery in a tertiary University Hospital. A total of 18 patients (36%) had a case of complicated HD, including simple communication of the cyst with the biliary tree (6 cases), rupture of the cyst into the biliary tree (6 cases), presence of a bronco-biliary fistula (2 cases), rupture of the cyst in the peritoneal cavity (2 cases), and rupture of the cyst and formation of a hepatic abscess (2 cases). Endoscopic retrograde cholangiopancreatography (ERCP) was pre-operatively performed on six patients. <i>Results:</i> The main clinical symptom presented was right upper quadrant pain in 16 patients (88%), which was associated with high fever (>39 °C) in 14 patients (78%). C-reactive protein (CRP) was the primary indicator of a complicated HD (<i>p</i> = 0.003); however, it was only elevated in 67% of cases. CRP was a more sensitive indicator of a rupture in the biliary tree cyst (<i>p</i> = 0.02). Computer tomography (CT) detected more cases (44%) of a complicated HD than ultrasonography (US) (25%); however, the difference was not statistically significant. <i>Conclusions:</i> For prevention and control of HD, a high suspicion of the disease leading to early referral to specialized centers, mainly in endemic areas, is required. Prior to surgical or percutaneous intervention, a combination of imaging and laboratory findings are essential in diagnosing a complicated case and avoiding unnecessary interventions.
format	article
author	Gregory Christodoulidis Athina A. Samara Alexandros Diamantis Theodoros Floros Ioanna-Konstantina Sgantzou Kostas-Sotirios Karakantas Prokopis-Andreas Zotos Antonios Koutras Michel B. Janho Konstantinos Tepetes
author_facet	Gregory Christodoulidis Athina A. Samara Alexandros Diamantis Theodoros Floros Ioanna-Konstantina Sgantzou Kostas-Sotirios Karakantas Prokopis-Andreas Zotos Antonios Koutras Michel B. Janho Konstantinos Tepetes
author_sort	Gregory Christodoulidis
title	Reaching the Challenging Diagnosis of Complicated Liver Hydatid Disease: A Single Institution’s Experience from an Endemic Area
title_short	Reaching the Challenging Diagnosis of Complicated Liver Hydatid Disease: A Single Institution’s Experience from an Endemic Area
title_full	Reaching the Challenging Diagnosis of Complicated Liver Hydatid Disease: A Single Institution’s Experience from an Endemic Area
title_fullStr	Reaching the Challenging Diagnosis of Complicated Liver Hydatid Disease: A Single Institution’s Experience from an Endemic Area
title_full_unstemmed	Reaching the Challenging Diagnosis of Complicated Liver Hydatid Disease: A Single Institution’s Experience from an Endemic Area
title_sort	reaching the challenging diagnosis of complicated liver hydatid disease: a single institution’s experience from an endemic area
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/9ede1b3902fe437bbb281d54a4f74dfc
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Reaching the Challenging Diagnosis of Complicated Liver Hydatid Disease: A Single Institution’s Experience from an Endemic Area

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