Unusual Localization of Hydatid Disease: Making Correct Diagnosis Intraoperatively and its Management

Abstract

The hydatid cyst is a cosmopolitan parasitic infection which constitutes a public health problem in our country and the breeding areas of developing countries. The gluteal localization of the hydatid cyst is exceptional among the muscular localization which makes only 1 to 5% of all cyst localizations. In this work, we present a retrospective study of a series of 3 cases of isolated and primary hydatid cysts in the gluteal muscle observed at the emergency department of visceral surgery at Ibn Sina Rabat Hospital. The aim of this study was to analyze the epidemiological, clinical, biological, radiological and therapeutic aspects of this condition. The predilection field was that of the woman, with an average age of 40 years, and without notion of contact with dogs. The clinical picture was represented in 66.6% by signs of compression of neighbouring structures (lumbosciatica, rectal compression), and in 33.3%, the symptomatology was poor, consisting of a painless, non-inflammatory muscle swelling progressively increasing in volume, and evolving slowly in a context of preservation of general condition. No associated visceral localization was detected in any of our 3 patients. Computed tomography confirmed the diagnosis, and enabled us to specify more precisely the location of the cyst and its relationships. The diagnosis was made intraoperatively in our case. Treatment consisted of surgical excision, supplemented in some cases by antiparasitic medical treatment. The results were generally satisfactory, and no cases of recurrence were reported in our case. Prophylaxis is the best way to combat this parasite in endemic areas.