Primary hydatid cyst of kidney ruptured into calyces
Primary hydatid cyst of kidney ruptured into calyces
Echinokokkose der Niere Radiopaedia • CC-by-nc-sa 3.0 • de
Renal hydatid infection is a very rare manifestation of hydatid disease.
For a general discussion, and for links to other system specific manifestations, please refer to the article on hydatid disease.
Epidemiology
Renal hydatid infection is seen in less than 5% of patients with hydatid disease .
Clinical presentation
Clinical manifestations are variable, and have polymorph symptomatology which is rarely specific . Hydaturia is a pathognomonic sign of renal hydatidosis and results from the rupture of a hydatid cyst into the collecting system .
Pathology
Infection is caused by a parasitic zoonosis with the Echinococcus tapeworm. The kidneys are the most commonly affected urinary organs, but bladder, prostate, seminal vesicles and testis can also be involved .
Radiographic features
Plain radiograph
The plain x-ray may show a soft-tissue mass or a ring-shaped calcification in the renal region.
Excretory urography
May demonstrate caliceal distortion, caliectasis and a non-functioning kidney, possibly caused by the mass effect of cystic lesions.
Ultrasound
May show anechoic lesions with well-defined margins.
CT
CT is more accurate and sensitive ,and shows a unilocular or multilocular cysts with or without peripheral calcifications . CT may also show a detached membrane, a multiloculated cyst with mixed internal density, and daughter cysts with lower density than the maternal matrix .
Treatment and prognosis
The surgical approach remains the treatment of choice; particularly using laparoscopy and the resection should be mostly conservative .
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