Combined abdomino-thoracic approach to hydatid cyst in superior-posterior segments of the liver

Abstract

Hydatid disease of the liver is a common problem in developing countries. We present a case of huge hydatid cyst in the superior-posterior segments of liver, which was managed through combined abdominothoracic approach. Surgical intervention was done first through subcostal incision followed by anterolateral thoracotomy through sixth intercostal space with circumferential incision in the diaphragm as exposure through the abdominal approach was inadequate. The cyst was drained and the cavity filled with omentum to obliterate the residual space. Patient recovered well and was discharged after 1 week. This approach is useful when access is inadequate to hydatid cysts in the superior and posterior parts of the liver.