Hydatidosis and the duodenum: A systematic review of the literature

BACKGROUND Injury to the duodenum(fistula formation,compression,or other complications)by a hydatid cyst(HC)is an exceptional complication.AIM To perform a systematic review of the literature on the fistulization of HC in the duodenum.METHODS Following PRISMA guidelines,a search for HC with duodenal involvement was carried out in the databases of PubMed,SCielo and EMBASE without time limits.RESULTS Fourteen patients were identified,seven men and seven women,with a mean age of 53.14 years(SD=17.65,range:28-78).Three out of the 14(21%)had HC relapse.The most frequent clinical manifestations were abdominal pain and nausea and/or vomiting.Various imaging studies were performed in almost all cases,the most commonly used being abdominal computed tomography(10/14,71%).A range of surgical techniques were reported,most frequently HC drainage(41%)and enucleations(16%).Ten of the 14 patients had no complications and one patient died.The follow-up period and recurrences could not be determined.CONCLUSION The most frequent symptoms were abdominal pain,nausea and vomiting.Computed tomography was the most used diagnostic imaging technique,and HC drainage and fistula closure via laparotomy was the most frequent treatment.However,all diagnostic and therapeutic options for HC fistulizing the duodenum had a low level of evidence.