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Hydatid echinococcosis - Diagnosis
Last reviewed: 03.07.2025
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Clinical symptoms of hydatid echinococcosis (a tumor-like, slowly growing formation in the liver, lungs or other organs) and epidemiological data allow one to suspect echinococcosis.
Seroimmunological diagnostics of hydatid echinococcosis (ELISA, RIGA, RLA) gives positive results in 90% of cases and more with liver damage, while the efficiency is lower (60%) with pulmonary echinococcosis. Antibody titers in the early period of invasion, with unopened or drug-untreated cysts, may be low or reactions may give negative results. Intradermal test with echinococcal antigen (known as Casoni reaction) is not currently used due to the frequent development of allergic complications. Parasitological diagnostics of hydatid echinococcosis is possible with a rupture of echinococcal cysts into the lumen of hollow organs - then scolexes or individual hooks of the parasite can be found in sputum, duodenal contents, feces.
X-ray diagnostics of hydatid echinococcosis, as well as ultrasound, CT and MRI allow us to assess the nature and prevalence of the process. In the lungs, X-rays reveal round, often irregularly shaped formations of uniform density; they do not calcify, while in about 50% of cases, a calcification ring is found around cysts in the liver. Small cysts are detected using tomography. Ultrasound is one of the most effective diagnostic methods for localizing echinococcosis of the liver and abdominal organs. Ultrasound, as a screening, allows us to determine the presence of a volumetric fluid formation in the liver and hypertension in the intra- and extrahepatic bile ducts. CT and MRI have a higher resolution. CT is used in complicated cases to clarify the localization of the cyst and its relationship with neighboring anatomical formations. The diagnostic algorithm for obstructive jaundice of echinococcal genesis must necessarily include ultrasound of the abdominal cavity, CT and ERCP with decompression of the bile ducts. In some cases, diagnostic laparoscopy is indicated (caution: the cyst cannot be punctured due to the risk of dissemination).
[ Indications for consultation with other specialists
In case of complicated course of hydatid echinococcosis (rupture of cyst, compression of vital organs), consultation with a surgeon is necessary to decide on surgical treatment.
Indications for hospitalization
Hospitalization and detailed diagnostics of hydatid echinococcosis are indicated in complicated cases of the disease.