RENAL HYDATID DISEASE: CLINICAL PRESENTATION, RADIOLOGICAL FINDINGS, AND MANAGEMENT OUTCOMES AT MOSUL AL SALAM TEACHING HOSPITAL

Background: Hydatid disease is mainly caused by Echinococcus granulosus, is an endemic in many parts of the world. After the patient ingests food contaminated by the eggs of the parasite, the embryos will lodge in several organs, including the kidney. The formation of germinal and laminated membranes causes the production of hydatid fluid, which is later replaced with organized or calcified membranes. Objectives: To review 20 cases with renal hydatid disease in terms of symptoms, findings, laboratory tests, radiological findings and treatment modalities. Methods: This is a retrospective case-series study was carried out at the urological department of Al-Salam Teaching Hospital in Mosul city during the period from October 2020 to October 2022. The study included patients who met one or more of the following criteria; radiological signs of renal hydatid disease on ultrasonography, computed tomography with surgical confirmation of kidney hydatid cysts. In addition to histopathological confirmation after surgical removal. Patients with hydatid disease in organs other than the kidney, patients with renal cystic lesions with alternate proven diagnoses (such as simple renal cysts, abscesses, or cystic renal malignancies) and those with insufficient imaging data. Results: Lumbar pain formed the most common presenting symptoms and were present in 80% of the patients in our study. Four patients had also other symptoms such as nausea, vomiting and malaise. Only five patients were females (25%). The left kidney was involved in eleven patients (55%) and the right kidney in nine (45%), The presence of multivesicular cysts with mixed density due to daughter cysts was characteristics of hydatid disease. Sixteen patients underwent nephrectomy (80%, four patients underwent marsupialization and albendazole medication chemotherapy. Conclusion: Renal hydatidosis is a rare entity and the main challenge is preoperative diagnosis. Radiological and serologic studies, although indicative, they cannot be conclusive for the diagnosis, and only pathologic examination after surgical removal can confirm echinococcal infection.