HYDATID CYST OF THE KIDNEY

  • 1 January 1980
    • journal article
    • research article
    • Vol. 86  (7) , 519-526
Abstract
A series of 78 cases, collected during the past 17 yr of hydatid cyst of the kidney is reported. The study material is based upon 72 IVU [i.v. urogram], 19 retrograde urograms, 22 renal arteriograms, 58 laboratory examinations, 12 renal echographies and 76 surgical operations. The usual presenting symptoms consisted of lumbar or lumbo-abdominal swellings, lumbar pain, renal colic, hydaturia and hematuria. Cysts of the upper pole of the right kidney may present with digestive problems as their 1st symptoms. Almost half of these cysts were calcified and the IVU indicated a renal tumor. In endemic areas, the presence of calcifications is fairly typical of hydatid cyst. In the absence of calcifications, the IVU appearance was that of a renal cyst or carcinoma. The diagnosis is based upon hydaturia, the existence of a 2nd hepatic or pulmonary lesion and positive serological reactions. Renal echotomography has radically transformed the diagnostic approach since it is reliable and shows identical appearances in the kidney to those found in hydatid cysts of the liver. The use of echography has made it possible to limit arteriography to heterogeneous masses with a solid component. Improved knowledge of echotomography should make it possible to avoid the topographical errors in which a renal hydatid cyst is thought to be in the liver. Treatment should be surgical, including sterilization of the cyst by the injection of hypertonic saline and removal of the hydatid cyst (cystectomy). After these basic steps the surgeon had decided between simple resection of the protruding part of the cyst (partial pericystectomy, 25 cases) or ablation of all the adventitia (total pericystectomy, 26 cases). When damage to the renal parenchyma was too extensive, nephrectomy was necessary (19 cases).

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