The aim of this retrospective study is to report on a series of 15 patients with abdominal
hydatid disease in uncommon sites submitted to surgery in our unit over the period 1974-2003. Eight women and 7 men (mean age: 48.4 years) were included in the study. The
hydatid cysts were located in the peritoneum in 8 patients, in the spleen in 5, in the kidney in 1 and in the retroperitoneum in 1. In 4 cases the peritoneal
cysts were solitary, while 4 patients in this subgroup presented multiple
cysts and 2 had concomitant liver
hydatidosis. The splenic
cysts were solitary in 2 cases, associated with a hepatic
cyst in 2 and with a lung
cyst in 1. The renal and retroperitoneal
cysts were both solitary. The diagnosis was made at operation in 3 cases, while in 12 patients it was made by serological tests, ultrasonography and/or CT. All patients were operated on: we performed a total
cystectomy in 7 patients with peritoneal
cysts and in the patient with a retroperitoneal location,
splenectomy in the 5 splenic
cysts and a
partial cystectomy with external drainage of the residual cavity in 1 peritoneal
cyst and in the renal location. The postoperative course was regular with no mortality and no major morbidity in 14 patients, while 1 patient submitted to
splenectomy developed a
subphrenic abscess that required surgical drainage. Two recurrences occurred in patients with peritoneal
cysts 71 and 20 months, respectively, after the first operation and these were managed by total
cystectomy. The diagnosis of uncommon abdominal sites of
hydatid disease is more accurate today because of the new imaging techniques, which are often able to show specific radiological signs of
hydatid disease. The treatment of choice is surgical and complete removal of the
cyst is the gold standard, but its feasibility is related to the location of the
cyst.