Dr AvinashTank, is a super-specialist (MCh) Laparoscopic Gastro-intestinal Surgeon,

LIVER HYDATID CYST

Hydatid cyst is an infection caused by a parasite named Echinococcus. The infection commonly manifests as a cyst (fluid filled cavity) in the liver (50–70%) and less frequently the lung, the spleen, the kidney, the bones, and the brain. This disease is also known as Echinococcal cyst, Hydatidosis; Hydatid disease, Hydatid cyst disease.

Risk Factor

Hydatid cyst is an infection caused by a parasite named Echinococcus. The infection commonly manifests as a cyst (fluid filled cavity) in the liver (50–70%) and less frequently the lung, the spleen, the kidney, the bones, and the brain. This disease is also known as Echinococcal cyst, Hydatidosis; Hydatid disease, Hydatid cyst disease.

 

Symptoms

A small hydatid cyst (< 5 cm) usually doesn’t cause any symptoms. Enlarging hydatid cyst may cause pain in the upper right part of the abdomen, fever, persistent itching, chest pain or cough. Complicated cysts may present with varied symptoms such as fever, jaundice or cough with blood in sputum.

 

Diagnosis

Usually liver hydatid cyst is diagnosed incidentally when investigated for another disease. The following tests may be done to find the cysts: blood tests, including liver function tests, ultrasound, abdominal CT scan.

 

Complications

Cyst infection, Cyst rupture in abdomen, bile-duct, lung or any nearby organ.

 

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Treatment

There are 3 type of treatment for hydatid cyst

Medical treatment: Its the first line of treatment. Anti-parasitic medicines (albendazole or mebendazole) are given for longer time (for upto 3 months).

Percutaneous treatment: Cyst is puncture under guidance of ultrasound then sclerosant (cyst wall damaging medicine) & protoscolicidal medicine is injected. This procedure is known as PAIR (Puncture, Aspiration of cyst content, Injection of protoscolicidal medicine and Re-aspiration of fluid. This treatment is suitable for univesicular type of hydatid cysts.

This treatment is not suitable for complicated hydatid cyst, deeply placed cyst or if cyst is close to major blood vessels of liver. In this situation, surgery is preferred treatment.

Surgery: Surgery is most preferred treatment for hydatid cyst. The cysts may have to be removed surgically when they do not respond to medical therapy or complications develop in the cysts. There are various types of surgical procedures described for treatment of hydatid cysts, the most complete removal is achieved by cysto-peri-cystectomy, which offers the best chance of cure from the infection, with least chances of recurrent infection.

DR. AVINASH TANK

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