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  • Title: [Hydatid cyst of the kidney (author's transl)].
    Author: Zmerli S, Ayed M, Arkam B.
    Journal: J Urol (Paris); 1980; 86(7):519-26. PubMed ID: 7452050.
    Abstract:
    The authors report a series of 78 cases of hydatid cyst of the kidney collected during the past 17 years. There study material is based upon 72 IVU, 19 retrograde urograms, 22 renal arteriograms, 58 laboratory examinations, 12 renal echographies and 76 surgical operations. The usual presenting symptoms consist of lumbar or lumbo-abdominal swellings, lumbar pain, renal colic, hydaturia and haematuria, whilst bearing in mind that cysts of the upper pole of the right kidney may present with digestive problems as their first symptoms. Almost half of these cysts were calcified. The appearances by IVU were of a renal tumour. In endemic areas, the presence of calcifications is fairly typical of hydatid cyst. In the absence of calcifications, the IVU appearance is that of a renal cyst or carcinoma. The diagnosis is based upon the following: hydaturia, the existence of a second hepatic or pulmonary lesion and positive serological reactions. Renal echotomography has radically transformed the diagnostic approach since although recent, this investigation is reliable and shows identical appearances in the kidney to those found in hydatid cysts of the liver. The use of echography has made it possible to limit arteriography to heterogeneous masses with a solid component. Improved knowledge of echotomography should make it possible to avoid the topographical errors in which a renal hydatid cyst is thought to be in the liver. In the opinion of the authors, treatment should be surgical, whatever the procedure including sterilisation of the cyst by the injection of hypertonic saline and removal of the hydatid, i.e. the cyst ("kystectomy"). After these basic steps the surgeon may decide between simple resection of the protruding part of the cyst (partial perikystectomy, 25 cases) or ablation of all the adventitia (total perikystectomy, 26 cases). When damage to the renal parenchyma is too extensive, nephrectomy may be necessary (19 cases).
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