Hydatid disease

Hydatid disease is characterized with the cystic lesions in the different organs of the body caused by a taenia, echinococcus granulosis. Liver is the most affected organ followed by the lungs. Diagnosis is not so difficult because of the situation that Turkey is one of the endemic counries in the world. Living in an endemic country, clinical probability, radiological imagining, and serological tests are sufficient enough to reach in diagnosis. The presence of cytic lesions in the family members and multiorgan involvement support the diagnosis. In recent years, the majority of the patients were referred to our institution for their incidentally found asymptomatic cysts because of deliberately used ultrasongraphic investigations for other reasons. Abdominal ultrasonography, abdominal and chest computerized tomographies, and serological tests are the main diagnostic modalities. Possible treatment options are; open surgery, laparoscopic approach, ultrasonography guided drainage procedure, surgery under the coverage of drug treatment, and drug treatment alone using albendazol. With the fear of having complications such as, spillage of the cyst content, incomplete clearance of the septated cysts, abscess formation in the remaining cavity, and the possibility of the recurrence, the laparoscopic intervention and ultrasonography guided drainage procedures are not preferred treatment modalities. Our treatment protocol has changed in the years, from operating every cyst to nonoperative treatment protocol with the use of albendazol alone in selected cases with hydatid disease. As a conclusion: in the operation, there is no point using any type of scolocidal agents. They can even be fatal. After cleaning the cystic cavity, open bile ducts could be found and repaired under direct vision by the maneouver described by the author. No attempt should be made to close or fill the cavity using stiches or an omental patch in liver cysts, they should be leave open to the peritoneal cavity after inserting tube drains into the cavity and at the bottom of the liver. Splenectomy under the coverage of the vaccination for the splenic cysts, partial cystectomy for the renal lesions, and suture ligation of the bronchial openings individualy and capittonage of the cavity for the lung cysts, are recommended. Since 1995, albendazol treatment have been used succesfully in patients without having any side effects or complications that need to stop the treatment protocol. We can remove the lebel of an endemic country from the name of Turkey with education, working together with veterinary society and probably, prophylactic usage of albendazol in the group of people who deal with cattle breeding. (Turk Arch Ped 2010; 45 Suppl: 55-8)