Cystic hydatid disease of the liver and lungs in Peruvian children: Clinical and surgical profile and associated factors in 219 cases (2014-2023).

Abstract

Introduction. Cystic echinococcosis is a major zoonotic disease from a public health perspective, with a high prevalence in rural areas of Peru. We analyzed the clinical characteristics and surgical treatment of hepatic and pulmonary cases in children from 2014 to 2023. Population and methods. This was a retrospective, cross-sectional study of 219 children diagnosed through imaging. The study evaluated sociodemographic variables (sex, rural origin, educational level, and parental occupation), clinical variables (symptoms, cyst location), surgical variables, and complications. Descriptive analysis, Pearson's chi-square test, and multivariate logistic regression were performed to assess location, independent predictive factors, and complications. Results. The disease predominantly affected males from rural or marginal urban areas. The most common symptoms were cough, abdominal pain, chest pain, and weight loss. In most cases, surgery was elective, with a short mean hospital stay and zero mortality. Complications were rare, such as biliary fistulas/liver abscesses and pneumothorax, with a higher risk in cases involving multiple cysts. Pulmonary involvement was associated with rural origin and contact with dogs. Contact with dogs, herding, and low socioeconomic status were identified as predictors of cystic echinococcosis; concurrent pulmonary and hepatic cysts and a diagnostic delay of >90 days were identified as predictors of complications. Conclusion. The disease is linked to rural poverty and zoonotic exposures (dogs, grazing), with clinical profiles that vary depending on the location of the cysts and higher morbidity in cases involving both the lungs and liver, with a predominance of pulmonary cysts. Zoonotic and social determinants are more significant than classic demographic factors. Surgical treatment combined with albendazole proved highly effective.