108 cases of hepatic hydatid cyst

: The paper reports on 108 cases of hepatic hydatidosis, admitted to the clinic in the last 12 years, who wer subjected systematically to hepatic imagery, immunologic investigation at hydatic antigen, determination of eosinophil and hepatic biochemical exploration. All the cases were checked operatively. The females were predominant, 66.11%, the average age was of 42.88 +/- 11.94 years. The greatest part of the cases ranged within the 5th-7th age decades. The investigation shows that there exists, in Romania, an endemic region infested with Echinococcus tenia in the Danube zone. The most frequent contamination sources were the cats and dogs; only in 11.11% of the cases the patients were breeding animals. The most cases were discovered late and had an important hepatomegaly. The patients sought help from the physician an ailment in the right hypochondria in 52.78% of the cases, followed by fever (16.68%), biliary colic (12.96%), abdominal pain; (9.26%) and incidentally in 12.04% of the cases. The medium diameter of the hydatic cyst at its discovery was of 10.65% +/- 5.84/14.06 +/- 7.12 cm; only in 21.3% of the cases the diameter of the cyst was lower than 6 cm. The causes of the late diagnosis were: sporadic hepatic imagistic exploration; sensibility of scintigraphy was of 87.5% whereas that of echography was of 98% and that of the CT-scanning od 100%; other cause was due to the lack of immunologic tests at hydatic antigen; sensibility of hemagglutination inhibition is of 65% and that of contra-immunoelectrophoresis of 86%. Owing to the late discovery of the disease, a lethal evolution was recorded by rupture of the cyst and peritoneal inundation in a young patient of 29 years old. Hepatic echinococcosis was unilocular in 74.07% of the case, with predominance in the right lobe (67.5%). The complications rate was of 14.83%, with predominance of the suppuration (10.19%). The paper confirms the endemic state of the hydatic disease, in the Danubian zone of Romania and pleads for the necessity of improving the diagnosis by systematic application of the echographic examination and of better immunologic tests in the ambulatory.