Abstract
Hydatid disease is a significant health problem in many livestock-rearing areas especially in the developing world, mainly caused by Echinococcus granulosus. The liver and lung are the most common affected sites. However, hydatid disease can occur anywhere in the body. Simultaneous involvement of two organs or sites is very unusual, mainly for organs other than the lung and liver. We thus report a very unusual combination of hepatic and left iliac fossa with hydatid disease in an adult patient. A 37-year-old farmer from a village presented with intermittent right upper quadrant and left iliac fossa pain associated with distention of abdomen for one month. Abdominal radiological investigations reported hydatid cyst disease; one cyst was found in the right lobe of the liver and another in the left iliac fossa. Positive IgG antibody by the ELISA test also confirmed the diagnosis. Pericystectomy and excision of hydatid cyst without spillage of content for the liver and left iliac fossa were done, respectively. Patient was discharged on the 10th postoperative day with an uneventful postoperative course. There was no recurrence of the lesion during one-year follow-up period. A combination of hydatid disease in the liver and iliac fossa is very unusual, so clinician should have thoughts regarding this rare entity as an important differential diagnosis.
Highlights
Hydatid disease is a helminthic infection caused by the larval stages of Echinococcus
The left iliac fossa involvement in hydatid disease is unusual and infestation of the left iliac fossa usually occurs by leakage into systemic circulation
Primary left iliac fossa hydatid disease is very uncommon entity accounting for just 2% of all intra-abdominal hydatid disease [5,6,7]
Summary
Hydatid disease (cystic echinococcosis) is a helminthic infection caused by the larval stages of Echinococcus. Echinococcus granulosus, Echinococcus multilocularis, and Echinococcus vogeli or Echinococcus oligarthrus are common echinococci documented clinically [1, 2]. This disease mainly affects the liver (70%) followed by the lungs (15–47%), kidney (2–4%), bones, and brain. This can be found anywhere in the body [3]. Hydatid cysts in left iliac fossa may occur as a part of dispersed disease or may occur in isolation. Due to the rarity of left iliac fossa hydatid disease, the possible coexistence of the disease in the liver is more likely. We are reporting infrequent coexistence of hepatic and left iliac fossa hydatid cyst in a young adult patient who was treated successfully without recurrence
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