Hydatid cyst of the colon: A systematic review of the literature

Table 1 Clinical data

Ref.	Sex	Age	Abdominal pain	Nausea and vomiting	Fever	Abdominal exploration	Past medical history	Current medical history
Sapkas et al[13], 1972	Male	70	Yes	NA	Yes (38-40 °C)	Spherical mass in left upper quadrant	NA	Splenic hydatid cyst
Ortiz et al[12], 1987	Female	75	Yes	NA	Yes (38.0 °C)	Epigastric and right upper-quadrant tenderness	Liver hydatid cyst treated with mebendazol	Hematemesis and substernal pyrosis
Puras et al[11], 1989	Male	81	Yes	NA	NA	Plastron in inferior hemiabdomen	Liver hydatid cyst; Intestinal obstruction secondary to intestinal adhesions (peritoneal hydatid cyst discovered but not treated); Left inguinal hernia/Amputation of lower left limb due to ischemia	Chronic constipation. Depositions with mucus in recent months. Last 4 d with melenas and abdominal pain
Leviav et al[10], 1996	Male	21	Yes	NA	NA	NA	NA	Abdominal trauma (soccer)
Lo Casto et al[9], 1997	Female	59	Yes	NA	Yes (38.5 °C)	A palpable mass found in the left upper quadrant	Dyspepsia	Anaphylactic reaction 10 d previously
Astarcioglu et al[8], 2001	Male	61	Yes	Vomiting	Yes	Abdominal distention	Unremarkable	-
Fernández Salazar et al[7], 2005	Female	73	Yes	Vomiting	NA	Splenomegaly and hepatomegaly	Liver hydatid cyst; Intestinal obstruction due to an abdominal plastron with two small hydatid cysts in peritoneum	Anorexia and weight loss
Teke et al[6], 2008	Female	77	No	NA	No (36.5 °C)	Mild tenderness in the left upper quadrant, with no rebound, guarding, mass or hepatosplenomegaly	Hypertension, Hysterectomy for uterine myoma	Hematochezia
Restivo et al[5], 2010	Male	64	Yes	Nausea and vomiting	No	Diffusely tender without guarding and rebound, no palpable masses	Constipation	Abdominal pain, nausea and vomiting

NA: Not available.

Table 2 Analytical, radiological and endoscopic studies

Ref.	Leukocytosis	Hydatid Serology	Abdominal X-ray	Ultrasound	CT	Contrast studies	Colonoscopy
Sapkas et al[13], 1972	NA	NA	Calcified splenic cyst	NA	NA	Adhesion cyst-left colon	NA
Ortiz et al[12], 1987	Shift to the left	NA	Elevated right hemidiaphragm	NA	Gas-filled cavity in the right lobe of the liver	Sliding hiatal hernia and fistula extending from the colon to the liver cavity	NA
Puras et al[11], 1989	No (3700/mm3)	Positive	No significant alterations	Intrabdominal cavity of 10.3 × 10.7 cm with cystic appearance	ND	Presence of fistula allows the filling of the hydatid cyst	Sigmoid fistula (3 cm) with opening to polycystic cavity at 23 cm from anal margin
Leviav et al[10], 1996	NA	NA	NA	NA	NA	NA	-
Lo Casto et al[9], 1997	Eosinophilia (20%)	NA	NA	Large oval mass with well-defined wall and a complex echo pattern. Hyperechoic tracts inside the wall with acoustic shadowing	Mass originated from the liver extending from left hemidiaphragm to sacro-iliac joint, situated between left transverse and descending segments of colon, partially calcified and with mixed density content (liquid with bubbles and air-fluid level)	NA	NA
Astarcioglu et al[8], 2001	Yes (21000 /mm3)	Positive	Dilated right and transverse colon; Left colonic obstruction	Dilated colonic segments and ascites	NA	NA	NA
Fernández Salazar et al[7], 2005	NA	NA	Large lobulated calcification of liver cyst with aerial content	Calcified cystic lesion (8.5 cm) in right hepatic lobe	Right hepatic lobe hypertrophy, 8 cm cystic cavity with calcified wall with intra and perilesional air	Hepatic cystic cavity filled with contrast in communication with the colon at the level of the hepatic angle	In hepatic angle, a blackish hemispherical stone structure inside which it was possible to access through a notch
Teke et al[6], 2008	Yes (18600/mm3)	NA	NA	NA	Ruptured cystic lesion (5.4 cm × 5.6 cm) in the inferior pole of the spleen. Hyperdense material filling the left colon and multiple cystic lesions in the abdominopelvic region. Gas in the cystic cavity	Extravasation of contrast at the level of splenic hilus and colon’s splenic flexure	Failed to show the source of the bleeding due to active major bleeding
Restivo et al[5], 2010	NA	NA	NA	NA	Colonic distention caused by a 6-cm intraluminal ovoidal cystic mass with peripheral calcification in the sigmoid colon	NA	The cyst was stuck to the mucosa (sigma)

NA: Not available.

Table 3 Intraoperative findings, postoperative period and follow-up

Ref.	Intraoperative findings	Surgical procedure	Postoperative period morbidity	Pathology	Postoperative albendazole	Follow-up
Sapkas et al[13], 1972	Giant splenic cyst. Communication splenic cyst to colon	Left colectomy with splenectomy (total cystectomy). Colo-colonic terminal anastomosis	2nd d: Low blood pressure, tachycardia, cyanosis in limbs, death	Isolated mesosigmoidal hydatid cyst	NA	Exitus on second postoperative day
Ortiz et al[12], 1987	Liver cyst. Communication liver cyst to colon	Excision of 5 cm of the colon wall surrounding the fistulous hole and closure of the colonic defect	NA	Calcified cystic lesion in right hepatic lobe with colonic fistula	NA	NA
Puras et al[11], 1989	Two peritoneal cysts of 6 and 10 cm. The larger one fistulized to colon	Total cystopericystectomies and sigmoidectomy with terminal anastomosis	Evisceration with wound closure surgery	Hydatid cyst	NA	NA
Leviav et al[10], 1996	Ruptured cyst in splenic flexure of colon with peritonitis	Resection of splenic flexure plus proximal colostomy. Partial cystectomy of liver cysts	First week: Fever (39 ºC). Subphrenic abscess	Splenic hydatid cyst invading the colon's splenic flexure	NA	No relapse. Followed-up during 12 yr
Lo Casto et al[9], 1997	Hydatid cyst originating from left lobe of the liver fistulized to the left colon	Partial cystectomy and suture of the colonic fistula	NA	Ruptured cyst in splenic flexure of colon with peritonitis	High-dose albendazole (6 mo)	No more surgeries required
Astarcioglu et al[8], 2001	Multiple obstructing hydatid cysts in the colon serosal tissue and mesosigmoid (1.5 - 6 cm ø)	Hartmann’s procedure with 15 cm of resected colonic segment	Uneventful	Peritoneal hydatid cysts fistulized to sigmoidal colon	200 mg/d oral albendazole	Free of disease 4 mo
Fernández Salazar et al[7], 2005	NA	Refused surgical treatment	NA	Calcified splenic cyst fistulizing left colon	Antiparasitic treatment but not specified	Good evolution 6 months after discharge
Teke et al[6], 2008	Disseminated abdominopelvic hydatid cysts, in the inferior pole of the spleen, and invading the colon's splenic flexure. Fistula between splenic hydatid cyst and colon's splenic flexure, (1 cm)	En-bloc excision of the spleen and splenic flexure of the colon	Uneventful	Hydatid cyst communicating with colon through a fistula	Three 28-d cycles of albendazole therapy	The patient was discharged on the seventh postoperatived
Restivo et al[5], 2010	Large fistula between the hepatic flexure and the liver	Partial cystectomy + suture colon	NA	Hydatid cyst in the right lobe of the liver fistulized in the right colon	NA	At 15-month follow up the patient was well and CT scan and colonoscopy showed a closure of the hepatic-colonic fistula

NA: Not available.