Hydatid disease of the ribs: An exceptional location

BACKGROUND: Hydatid disease is a zoonosis caused by larval stages of cestodes belonging to the genus Echinococcus. The rib location is exceptional. It presents a real diagnostic and therapeutic challenge. OBJECTIVES: To describe the clinical, serological and radiological features and surgical management of rib hydatidosis. METHODS: This is a retrospective study conducted over 4 years, on five cases of rib hydatidosis. We analysed the clinical and radiological presentations and the adopted therapeutic procedure. RESULTS: The average age of our patients was 44 years, without gender predominance. The clinical signs were dominated by the presence of an immobile swelling of fluid consistency without inflammatory sign, accompanied by moderate and intermittent localised pain. The laboratory assessment was nonspecific. The radiological assessment, including chest X-ray and thoracic computed tomography, with and without contrast, was essential in order to assess the extent of the lesion. Thoracic magnetic resonance imaging was requested in one case because of suspicions of a spinal extension. All of our patients underwent a rib excision accompanied by medical treatment of albendazole 24 hours after the surgery. The follow-up ranged from 1 year to 4 years and did not show any recurrence. CONCLUSION: Hydatidosis of the ribs is an exceptional location of hydatid disease. The diagnosis was based on radiology and intraoperative exploration. The treatment remained essentially surgical by rib excision with anthelmintic drugs to prevent recurrence.