Frider B, Larrieu E, Odriozola M
Division of Internal Medicine, Hepatology Unit, Argerich County Hospital, Associated to the University of Buenos Aires, Argentina.
J Hepatol. 1999 Feb;30(2):228-31. doi: 10.1016/s0168-8278(99)80066-x.
BACKGROUND/AIMS: The aim of this study was to determine the outcome of asymptomatic liver hydatid cysts in a cohort of 33 out of 59 carriers by evaluating clinical and ultrasonographic (US) changes 10-12 years after initial diagnosis.
We compared US features and cyst size with the original descriptions from 1984-1986. Patients were questioned about hydatid-related symptoms and signs.
Thirty-three of the 59 carriers could be reevaluated, five (15.2%) of whom had undergone surgery without presenting symptoms, while of 28 unoperated cases, 21 (75%) remained asymptomatic. Of the unoperated cases evaluated by US, in 8/14 (57.1%) there were no modifications in cyst size during the 10-12-year period, in five (35.7%) growth was slight (<3 cm) and in one (7.1%) the cyst grew 4 cm. Mean cyst growth in all 14 cases was 0.7 cm.
Despite the limited number of cases, our results show that most asymptomatic liver hydatid cases (75%) remain symptom-free for more than 10 years, regardless of cyst size or type. We believe that such carriers are at low risk of developing complications, so that it is difficult to establish specific rules for their therapy, if any. Longitudinal follow-up of larger series of asymptomatic hepatic hydatidosis cases is essential to gain a deeper insight into the natural history of such patients, and to draw up comprehensive guidelines for treatment.
背景/目的：本研究的目的是通过评估59名携带者中33名在初次诊断后10 - 12年的临床和超声（US）变化，来确定无症状肝包虫囊肿的转归。
我们将超声特征和囊肿大小与1984 - 1986年的原始描述进行了比较。对患者询问了与包虫相关的症状和体征。
59名携带者中有33名可以进行重新评估，其中5名（15.2%）在未出现症状的情况下接受了手术，而在28例未手术的病例中，21例（75%）仍无症状。在接受超声评估的未手术病例中，14例中有8例（57.1%）在10 - 12年期间囊肿大小无变化，5例（35.7%）生长轻微（<3 cm），1例（7.1%）囊肿增大了4 cm。所有14例病例的平均囊肿生长为0.7 cm。
尽管病例数量有限，但我们的结果表明，大多数无症状肝包虫病例（75%）在10年以上无症状，无论囊肿大小或类型如何。我们认为这些携带者发生并发症的风险较低，因此难以制定针对他们的具体治疗规则（如果有的话）。对更多系列无症状肝包虫病病例进行纵向随访对于更深入了解此类患者的自然病程以及制定全面的治疗指南至关重要。
