Hydatid disease in people is mainly caused by infection with the larval stage of the dog tapeworm Echinococcus granulosus.

Causes

It is an important pathogenic, zoonotic and parasitic infection (acquired from animals) of humans, following ingestion of tapeworm eggs excreted in the faeces of infected dogs.

Presentation

Cystic hydatid disease usually affects the liver (50–70%) and less frequently the lung, the spleen, the kidney, the bones, and the brain.

Complications of Liver Hydatid Cyst

• Dissemination or anaphylaxis after a cyst ruptures into the peritoneum or biliary tract.
• Infection of the cyst can facilitate the development of liver abscesses
• mechanic local complications, such as mass effect on bile ducts and vessels that can induce cholestasis, portal hypertension, and Budd-Chiari syndrome.

Treatment

The modern treatment of hydatid cyst of the liver varies from surgical intervention to percutaneous drainage or medical therapy. Surgery is still the treatment of choice and can be performed by the conventional or laparoscopic approach.

Percutaneous Aspiration-Injection-Reaspiration Drainage (PAIR) seems to be a better alternative to surgery in selected cases.

Laparoscopic interventions are primarily suited for cysts located superficially on the anterior surface of the liver without communicating with the biliary tree. They can also be attempted in the case of multiple cysts (but fewer than three).

Contraindications of Laparoscopy

• Cyst rupture in the biliary tree
• Central cyst localization
• Cystic dimensions over 15 cm
• Thickened or calcified cystic walls