Hydatid disease in New Zealand. What remains and how should we treat it?
OBJECTIVE
The incidence of hydatid disease in New Zealand has steadily declined since the introduction of control measures in the early 1960s. However, patients continue to present for management of newly recognised, disseminated or recurrent disease. It is desirable that doctors in New Zealand have some knowledge of current patterns of presentation and management of the disease.


METHODS
Twenty-five patients with hydatid disease have been seen and managed over a ten-year period by one hepato-biliary surgeon. Their presentation and management is outlined and discussed. Surgery, after pre-treatment with albendazole, was undertaken in 15 patients where eradication seemed possible and desirable and in three others presenting with complications (infection, rupture, fistulation). Albendazole treatment alone was used in six patients (five with uncomplicated recurrent or disseminated disease) and one patient has simply been observed.


RESULTS
There were no deaths in 18 patients who underwent surgery and no recurrent disease has been found. Major morbidity was confined to those having surgery for complications. All six patients who received albenzadole alone had a good clinical and radiological response, though they required follow-up.


CONCLUSIONS
It is suggested that surgery (with albendazole pre-treatment) should be reserved for those with either curable disease or complications and that all others should be managed, in the first instance, by albendazole alone. Providing treatment is instituted before complications develop it should be associated with minimal morbidity.
Lynch
A C
AC
Wakefield Gastroenterology Centre, Wakefield Hospital, Wellington.
Stubbs
R S
RS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015766:Albendazole / Q000627:therapeutic use*; D000465:Algorithms; D000923:Anticestodal Agents / Q000627:therapeutic use*; D003663:Decision Trees; D018563:Disease Notification; D004443:Echinococcosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D018579:Patient Selection; D011292:Premedication / Q000379:methods*; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000923:Anticestodal Agents; D015766:Albendazole