Hydatid cyst of Liver

Hydatid cyst of liver is caused by a parasitic infection caused by Echinococcus tapeworm that leads to formation of cysts in the liver. The infection in humans is contracted from contaminated food or with close contact with dogs.

Hydatid cyst of liver is usually diagnosed on imaging studies such as USG abdomen, CT or MRI scan. Based on the imaging features these cysts may be classified into Type I, Type II or Type III.

Hydatid serology test is an important adjunct that helps in diagnosis of the disease.

Treatment of Hydatid cyst is mandatory because the cyst usually keeps growing and may lead to complications such as secondary infection, abnormal communication with bile duct, spontaneous rupture into abdomen or chest. However, Type III cysts are inactive or dead and hence surgery is indicated only in selected patients in whom cyst is causing symptoms due to pressure over surrounding structures or any other complication.

Albendazole is the drug of choice against hydatid disease. Use of Albendazole prior to surgery reduces the risk of recurrence and facilitates surgery by decreasing pressure in the cyst. The recommended dose of albendazole for an adult weighing 60 kg or more is 400 mg two times daily.  Albendazole should be started 4-30 days prior to surgery and continued at least for 1 month after surgery.

The treatment of the hydatid cyst is advised based on the size and location of the cyst.

– For small cysts less then 5 cm treatment is non-surgical that includes medications & percutaneous drainage (PAIR)

– For larger cysts surgery is the mainstay of treatment. Surgical options include:

Laparoscopic hydatid cyst evacuation and omentoplasty