Q:

The following statement(s) is/are true concerning the diagnosis and treatment of hydatid cysts

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The following statement(s) is/are true concerning the diagnosis and treatment of hydatid cysts.


  1. Percutaneous aspiration is an important aspect of diagnosis and treatment of a hydatid cyst
  2. CT scan will oftentimes show the classic findings of a cystic liver lesion with a calcific rim
  3. At operation, care must be taken to protect the operative field from spillage of the cyst fluid
  4. The use of a scoleocide has become obsolete with current surgical techniques

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b. CT scan will oftentimes show the classic findings of a cystic liver lesion with a calcific rim

c. At operation, care must be taken to protect the operative field from spillage of the cyst fluid

Hydatid cysts are most commonly the result of infection with the tape worm, Echinococcus granulosis. Routine laboratory tests in patients with hydatid cysts are normal or nonspecifically abnormal. Although routine chest or abdominal radiographs may show a mass with a calcific rim, sonography and CT scan are the favored means of imaging hydatid cysts. The presence of calcifications and daughter cysts within the parent cyst suggests Echinococcus. Percutaneous needling of a hydatid cyst is unwise unless precautions against anaphylaxis are undertaken. A cyst’s fluid is often under pressure, and needling may precipitate rupture with the potential for anaphylaxis or intraperitoneal seating. The classic treatment of hydatid cysts is operative. The surgical aim is to remove the cyst or cysts without dissemination of the organism. At operation, the cyst is drained of fluid through a cannula after carefully protecting the operative field from fluid leakage. If the aspirate is clear a parasiticidal fluid (ethyl alcohol or 20% sterile saline) is injected into the cyst to kill any adherent scoleces. The cyst contents and the pericystic wall is then removed with careful surgical dissection.

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