[Hydatid cyst of the kidney based on a series of 34 cases].
OBJECTIVE
Hydatid disease is endemic in some countries, where it constitutes a real public health problem. It can affect any, but the kidney is a relatively rare site, representing 2% to 4% of all visceral sites. Renal hydatid cyst only presents at the stage of complications. Laboratory tests may suggest the diagnosis, which is confirmed by radiology. Renal hydatid cyst raises therapeutic problems making conservative surgery difficult. The objective of this paper is the find the best adapted treatment.


METHODS
34 consecutive cases of renal hydatid cyst (1980-2001) were observed in 23 men and 11 women with a mean age of 42 years (range: 15-73 years). The clinical features were dominated by pain (63%), a mass (26%), hydaturia (11.4%), haematuria (31.4%), prolonged fever (23%) and hypertension (3%). Intravenous urography performed in all patients showed calcifications in 5 cases, a mass syndrome in 11 cases and silent kidney in 2 cases. Abdominal CT, performed in 8 patients, was necessary whenever the diagnosis remained uncertain, particularly in the case of pseudoneoplastic cysts. However, ultrasonography, performed in 30 patients, remains the preferred diagnostic examination.


RESULTS
Treatment consisted of resection of the prominent dome in 23 cases, pericystectomy in 5 cases, 1 partial nephrectomy and 6 total nephrectomies. An associated procedure was performed during the same operation (hepatic, peritoneal hydatid cyst) in 3 cases, and was deferred (pulmonary hydatid cyst) in 1 case. The postoperative course was marked by urinary fistula in 2 cases and suppuration of the residual cavity in 1 case, treated by ultrasound-guided aspiration-drainage.


CONCLUSIONS
The resection of the prominent dome is the most adapted treatment whenever possible.
Services d'Urologie, Hôpitaux Militaires d'Instruction de Rabat et de Meknès, Maroc. ahmedameur1@caramail.com
Ahmed
A
Ameur
Mohamed
M
Lezrek
Hassan
H
Boumdin
Driss
D
Touiti
Mohamed
M
Abbar
Amoqrane
A
Beddouch
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D004443:Echinococcosis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000469:parasitology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009018:Morocco; D012189:Retrospective Studies; D013621:Taenia