In vitro efficacy of different chemical substances on hydatid cyst components

Aim: Cyst membrane, daughter cyst, and pericyst are the focal point of some problems related to the percutaneous treatment of hydatid disease. This study was planned to investigate the in vitro efficacy of sodium hypochlorite, hydrogen peroxide, some widely used scolicidal agents, and some chemical solvents on hydatid cyst components. Materials and methods: To investigate the effects of various pharmacological and chemical agents on hydatid cyst components, 5 mL each of 15 different agents was put into bottles. Tissue measuring 2 x 1 cm was cut from the pericyst and the cyst membrane was put into each bottle. Two undamaged daughter cysts obtained from the same cyst were added to the bottles. Evaluation was made by visual observation at different intervals over 20 days. Any change in the cyst membranes, daughter cysts, and pericysts including perforation, translucency, destruction, swelling, and melting were recorded and scored. Results: Hydrogen peroxide was the only agent with maximal effect on the 3 components. One percent sodium hypochlorite solution was also effective and the fastest acting agent on the cyst membranes and daughter cysts. Alcohol had no effect on any of the 3 components. Hypertonic saline had a minimal effect on the cyst membrane and no effect on the pericyst and daughter cysts. Ursodeoxycholic acid and silver nitrate were moderately effective on the pericyst. No chemical solvent was effective on the hydatid cyst contents. Conclusion: Hydrogen peroxide had the maximal effect on all 3 components of the cyst. Sodium hypochlorite was effective on daughter cysts and cyst membranes and slightly effective on pericysts and it appears to be a good agent to be used in percutaneous drainage. However, further studies on the effect of sodium hypochlorite should be carried out in vitro and then its in vivo efficacy should be investigated.