Hydatidosis in childhood.

A series of 45 children treated during the period 1959-1978 at the American University of Beirut Hospital is reported. Their ages ranged from 3-15 years. The organs affected were the lungs (67% of cases), liver (40% of cases), brain (9% of cases), kidney, neck and heart (two patients each). Multiple organ affection was noted in nine patients (20%). Because of this distribution and the presence of multiple cysts in the same organ, these patients required 64 surgical procedures for their treatment. The frequency of nonreactors to CF and IHA tests done on 33 patients was 36%, of whom 2 patients had multiple organ involvement. A false preoperative diagnosis was made in 11% of cases. Endocystectomy is the procedure of choice in most cases, combined either with marsupialization of the pericyst to the body cavity, or with closure of the pericyst if the cyst is not infected. Primary pulmonary lobectomy was resorted to in 23% of patients with lung cysts. Aqueous cetrimide solution (1/1000) has been used exclusively as a scolicidal agent during the last 10 years. The transdiaphragmatic approach to cysts in the dome of the liver is recommended and was used in four patients. Selective endobronchial intubation of the contralateral safe lung was used in six patients with lung cysts to prevent aspiration pneumonia and to make the dissection technically simpler. Three deaths were recorded early in this series giving a mortality rate of 6.7%. Methods for reducing complications and mortality are described.