Abstract

RETO VALIENTE, Luz Victoria et al. Clinical and therapeutic issues in children and adolescents with liver hidatidosis at the Hipolito Unanue National Hospital. Rev. gastroenterol. Perú [online]. 2012, vol.32, n.3, pp.290-296. ISSN 1022-5129.

The aim of this study is to evaluate the clinical diagnosis and treatment of pediatrics patients with hepatic hydatid disease hospitalized in the pediatric ward of HNHU in the last ten years. The study is a descriptive, cross-sectional and retrospective observational of patients undergoing surgery for liver hydatidosis. We studied 42 confirmed cases of hepatic hydatidosis, the ages ranged from 1 to 17 years and most were adolescents 13 to 17 years (20 cases 47.62%), the gender distribution is equal and the source of patients is mainly from the Central Andes of Peru (24 cases 57.14%) followed by Lima city (10 cases 23.81%). The most common presenting symptom was abdåominal pain (29 cases 69.05%) followed by fever (19 cases 45.24%). Ultrasound is the most common diagnostic method and only not done in a patient carrying a prior CT scan. Serology (indirect immunofluorescence) was positive in only 19 of 27 patients who had the test (70%). Most were single hepatic cysts (22 cases 52.38%) with size from 3 to 20 cm but most commonly they were 5 to 10 cm sized. The location was predominant on the right lobe (26 cases 61.98%) followed on both lobes (10 cases 23.81%). Apart from the liver there were cysts on the lungs (18 cases 42.86%). The surgical procedure performed was radical cystectomy with or without drainage in 36 cases (85.71%). And conservative surgery in only 6 cases (14.28). The important complications were: 15 cases of fever (35.71), nosocomial respiratory infection in 9 cases (21.43%), biliary fistula in 5 cases (11.90%) and residual abscess in 3 cases (7.14%). Although morbidity was high, mortality of the cases studied was zero.

Keywords : hepatic hydatidosis; echinococcosis; hydatid cyst.

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