Hydatid cysts in muscle: a modified percutaneous treatment approach.
BACKGROUND
Any organ in the human body may be affected by hydatid disease, but the liver and the lungs are most commonly affected. A rare localization of hydatid disease is within muscle tissue. Herein we present three patients with muscular hydatid disease who were successfully treated with a modified percutaneous approach.


METHODS
Patients with Gharbi type III cysts were treated on an outpatient basis. All procedures were performed under ultrasound guidance in the ultrasonography unit of our department. After local anesthesia, percutaneous puncture was performed in a one-step procedure. After free drainage stopped, absolute ethanol and polidocanol were injected into the cyst cavity. After the procedure, the patient was observed for at least six hours for any adverse reactions and sent home. Patients were followed-up with ultrasonography. A positive treatment effect was characterized by a reduction of the cyst's pseudo-tumor pattern and size, and by detachment of the germinal membrane.


RESULTS
The three patients in this report had a total of five hydatid cysts in muscle tissue and were all successfully treated with a modified percutaneous approach without recurrence.


CONCLUSIONS
Percutaneous drainage without re-aspiration is simple, easy to apply, low cost, repeatable, and does not require hospitalization. There have been no reported deaths associated with the procedure and morbidity is very low. When the technique is applied properly, relapses do not occur. With its low complication rate and its suitability for outpatient treatment, this method can be an alternative to surgery or puncture, aspiration, injection, and re-aspiration (PAIR) in selected patients.
Ormeci
Necati
N
Department of Gastroenterology, Ankara University Medical School, Ibn'i Sina Hospital, Sihhiye, Ankara, 06100 Turkey. normeci@yahoo.com
Idilman
Ramazan
R
Akyar
Serdar
S
Palabiyikoğlu
Murat
M
Coban
Sahin
S
Erdem
Hakan
H
Ekiz
Fuat
F
D000279:Administration, Cutaneous; D000328:Adult; D000818:Animals; D004322:Drainage; D004443:Echinococcosis / Q000000981:diagnostic imaging / Q000628:therapy*; D000431:Ethanol / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000469:parasitology*; D009135:Muscular Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011677:Punctures; D014463:Ultrasonography
D000077423:Polidocanol; D000431:Ethanol; D011092:Polyethylene Glycols