Liver cystic echinococcosis: A retrospective study on the demographics and clinical profile of patients managed at a single tertiary institution in central Eastern Cape Province, South Africa

Authors

  • A Govindasamy Department of Surgery, Frere Hospital and Faculty of Health Sciences, Walter Sisulu University, East London, South Africa
  • P R Bhattarai Department of Surgery, Frere Hospital and Faculty of Health Sciences, Walter Sisulu University, East London, South Africa
  • J van Niekerk Department of Surgery, Cecilia Makiwane Hospital, East London, South Africa
  • J John Division of Urology, Department of Surgery, Frere Hospital and Faculty of Health Sciences, Walter Sisulu University, East London, South Africa; Division of Urology, Department of Surgery, University of Cape Town, South Africa

DOI:

https://doi.org/10.7196/SAMJ.2024.v114i5.2195

Keywords:

Liver cystic echinococcosis

Abstract

Background. Cystic echinococcosis (CE) is a zoonotic disease with an Africa-wide prevalence of 1.7%. CE is caused by the tapeworm Echinococcus granulosus sensu lato, with the liver being the most commonly affected organ. In South Africa (SA), there is a paucity of data on liver CE demographics and management.

Objectives. To describe the demographics and clinical profile of patients with liver CE in a single tertiary hospital in Eastern Cape Province, SA.

Methods. A 4-year (2019 - 2022) retrospective clinical record review study was conducted on patients presenting with liver CE to the Department of Surgery at Frere Hospital. The demographics, clinical characteristics and management of patients with liver CE are reported.

Results. A total of 56 patients diagnosed with and managed for liver CE were included in the study. The mean age of the patients was 37.5 years. Abdominal pain (n=39; 69.6%) was the most common presenting symptom, and a palpable abdominal mass (n=36; 64.3%) was the predominant presenting sign. Most patients had disease confined to the liver (n=35; 62.5%). The right lobe of the liver was most commonly affected (n=38; 67.9%), and most patients had a single liver cyst on imaging (n=32; 57.1%). The majority of the patients (n=36; 64.3%) were managed with surgical partial cystectomy, with a perioperative bile leak being the most common complication.

Conclusion. In our setting, liver CE contributes to a significant local burden of the disease. The disease often has a nonspecific clinical presentation, necessitating imaging for the diagnosis. We observed good short-term outcomes in patients managed with combined partial cystectomy and medical therapy, although there is a risk of perioperative bile leak.

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Published

2024-05-09

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CME

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1.
Govindasamy A, Bhattarai PR, van Niekerk J, John J. Liver cystic echinococcosis: A retrospective study on the demographics and clinical profile of patients managed at a single tertiary institution in central Eastern Cape Province, South Africa. S Afr Med J [Internet]. 2024 May 9 [cited 2024 May 19];114(5):e2195. Available from: https://samajournals.co.za/index.php/samj/article/view/2195

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