Large Hydatid Cyst Research Articles

Resolution of infertility following hydatid cyst removal: a case report

Introduction and Importance: Human echinococcosis, also known as ‘Hydatid cyst,’ constitutes a zoonotic parasitic disease attributed to Echinococcus granulosus or Echinococcus multilocularis. Primary afflictions occur in the liver and lungs, whilst the implication of alternative organs remains infrequent. The clinical presentation can vary and large cysts may cause compression symptoms and complications. This case involved a 21-year-old Palestinian female with three large hydatid cysts in the liver, causing compression of adjacent structures and unique clinical manifestations. Case Presentation: A female-aged 21 arrived with signs of heart palpitations, shortness of breath, tiredness, and pain in the right upper abdomen, alongside a background of infertility. During routine pre-IVF ultrasound, three liver hydatid cysts were unexpectedly found, leading to a referral to the surgical department. Laboratory tests and imaging confirmed this diagnosis. Surgery involved cyst aspiration, hypertonic saline injection, and marsupialization. Postsurgical complications were managed as they occurred. The symptoms lessened afterwards, and a successful pregnancy was achieved nine months post-surgery. Clinical Discussion: Zoonotic infection by cystic echinococcosis (CE) primarily engages liver and lungs. The progression of symptoms is contingent upon cyst placement and resultant pressure on adjacent tissues. Diagnosis requires imaging alongside serological assays, while large cysts necessitate surgical intervention. Conclusion: The presented case underscores the complexity in managing multiple extensive liver hydatid cysts, highlighting the necessity to consider hydatid disease amidst patients presenting with indeterminate symptoms, particularly within endemic zones. An extensive surgical strategy produced positive outcomes, illustrating the significance of prompt intervention for symptom alleviation and sustained patient health.

Treatment of a Large Gluteal Hydatid Cyst in Syria Using a Manual Negative Pressure Wound Therapy Device (PragmaVAC)

AbstractThe lungs and liver are the most common sites of hydatid cysts, but they may also be found in other organs. We report the case of a lady in her 50s who presented to a hospital in northwest Syria with a large swelling in the right gluteal region. This was diagnosed as a gluteal abscess, and an incision and drainage were performed. Intraoperatively, a hydatid cyst germinal membrane was noted. She had the required imaging to exclude other cysts, which revealed a liver hydatid cyst of 7.5 cm, which was treated with PAIR (puncture, aspiration, injection, and re-aspiration) and albendazole. The residual wound was closed using a manual vacuum-assisted closure (VAC) pump for seven days. A key lesson is that a hydatid cyst in the gluteal muscles, though rare, should be considered in the differential diagnosis. We also show that the innovative use of a manual VAC pump can be used to support closure of large hydatid cyst cavities in muscles.

Incidental Left Ventricular Hydatid Cyst in a Patient with Chest Pain: A Case Report

Hydatid disease is an indolent parasitic infection caused by Echinococcus. The disease is transmitted through the ingestion of uncooked, contaminated vegetables and can infect almost any human organ, commonly the liver, followed by the lung, and rarely the heart. A computed tomography scan is the modality of choice for identifying hydatid cysts, and magnetic resonance imaging is for identifying complications. The definitive treatment includes surgery, with the possible use of antihelmintics in inoperable cases. To avoid fatal complications, hydatid disease must be treated as soon as it is diagnosed. This case highlights a peasant farmer rearing livestock who presented with chest pain and was incidentally found to have a mass in the left ventricle by transthoracic echocardiography. Further imaging found a large hydatid cyst in the left ventricular wall that was causing chest pain, possibly from the mass effect or compression of the left anterior descending artery.

Anesthetic Management of Large Hydatid Cyst Removal: A Case Report

Anesthetic management approach to achieve optimal outcome in hydatid cyst removal surgery is essential to prevent the dreaded intraoperative complication the anaphylaxis. Hydatid cysts are parasitic infections caused by Echinococcus granulosus. Laparoscopic large hydatid Cyst removal surgeries offer enhanced post-surgery benefits. Anesthesia plays a crucial role in ensuring optimal patient outcomes. This case report discusses the essential aspects of anesthetic management for such procedures.

Anesthetic Management of Large Hydatid Cyst Removal: A Case Report

Anesthetic management approach to achieve optimal outcome in hydatid cyst removal surgery is essential to prevent the dreaded intraoperative complication the anaphylaxis. Hydatid cysts are parasitic infections caused by Echinococcus granulosus. Laparoscopic large hydatid Cyst removal surgeries offer enhanced post-surgery benefits. Anesthesia plays a crucial role in ensuring optimal patient outcomes. This case report discusses the essential aspects of anesthetic management for such procedures.

Central Pericystectomy for Hydatid Cyst Treatment

BackgroundCompared to open resection for hepatic hydatid cysts, a laparoscopic approach may combine the benefit of reduced morbidity with complete cyst removal. Nonetheless, intraoperative cyst rupture during a laparoscopic approach due to reduced tactile feedback is a valid concern.1-3 Today, the laparoscopic experience remains limited even in high incidence regions.4 Here, a structured approach to laparoscopic pericystectomy is demonstrated. PatientA 37-year-old male from Uruguay presents with worsening abdominal pain, nausea, and vomiting. A 4-phase liver CT shows a large complex liver cyst (8.8 × 8.2 × 11.3 cm), encompassing the left hepatic lobe while abutting right hepatic vein (RHV), anterior fissure vein (AFV) and inferior vena cava (IVC). Further, the cyst causes mass effect on the hepatic vein vasculature. CT appearance is consistent with a large hydatid cyst with distorted hepatic anatomy resulting in compensatory hypertrophy of segments II, VI and VII. Appropriate institutional review board (IRB) and inform consent was obtained. TechniqueFollowing neoadjuvant albendazole for 4 weeks to minimize any effects in case of inadvertent cyst spillage, the patient tested negative for echinococcal antibody. For surgical planning, the patient’s anatomy was modeled to optimize the understanding of the complex spatial relationship between cyst, portal pedicle and hepatic veins. Further, port sites were preoperatively modelled to optimize port placement in the context of the altered anatomy from compensatory hepatic hypertrophy. During surgery, with the patient in a modified French position, the liver was completely mobilized. Then, a parenchymal transection plane was developed guided by RHV, AFV and IVC, while biliary radicals entering directly into the cyst were controlled individually. The complex transection plane resulted in preservation of the unaffected liver segments I, II, VI and VII. ConclusionThe multimodal approach demonstrated here included pretreatment with albendazole followed by safe laparoscopic pericystectomy. In the preoperative setting, albendazole can reduce the risk of recurrence if spillage occurs during surgery. In inoperable patients, it has been previously shown to be an effective monotherapy for small (< 5 cm) CE1 and CE3a cysts.5 For preoperative planning, an automated image reconstruction software (Fujifilm Synapse 3D) is used. The software creates a 3D model of the liver segmentation and vessels from contrast-enhanced CT and MR images. In addition to modelling the liver, port placement in relation to the liver is being simulated prior to surgery to optimize port placement at the time of surgery. During the case, the parenchymal transection is guided by RHV, AFV and IVC. The common postoperative complication of persistent biliary leakage was avoided by controlling each biliary radicals entering the cyst from the liver parenchyma. Biliary leaks are a common complication and have been positively correlated with the cyst diameter (~ 79% of cysts with diameter of 7.5 cm or greater have cysto-biliary fistula).6 In this context, indocyanine green may help to identify relevant biliary radicals entering the cyst or aid in recognizing bile leaks. If the stepwise approach described here is followed, minimally invasive pericystectomy represents a safe alternative to open surgery, harnessing the advantages of minimal risk of recurrence due to complete cyst removal and low morbidity.

Spontaneous Intraperitoneal Rupture of Hydatid Cysts of the Liver with Encapsulating Peritonitis: A Case Report

Background: Spontaneous rupture of a hepatic hydatid cyst resulting in biliary peritonitis is an infrequent but severe complication that requires urgent surgical intervention and has high rates of morbidity and mortality. There are very few reported cases of this complication in the medical literature.&#x0D; Case Presentation: We present an unusual case of a 64-year-old male who presented with acute peritonitis due to biliary peritonitis resulting from the spontaneous rupture of a large hydatid cyst of the liver, as seen on contrast-enhanced computed tomography, which also showed intraperitoneal fluid. During the operation, approximately 4L of infected bile was found in the peritoneal cavity, and a cystobiliary communication was observed with rupture of the anterior wall of the cyst. Treatment involved unroofing the cyst and closing the communication. The patient was free of recurrence and in good health after 6 months of follow-up.&#x0D; Conclusion: Although this complication is rare, it should be considered in the differential diagnosis of acute abdominal pain in patients living in endemic areas.

Anesthetic challenges in a case of hydatid cyst of liver posted for laparoscopic-assisted excision of the cyst

Hydatid cyst caused by Echinococcus granulosus is a common health problem in developing countries. The rupture of hydatid cyst can cause anaphylactic shock or even death during the surgical treatment. We present a report regarding anaphylactic reaction due to surgery to the liver for a hydatid cyst. Clinical examination and contrast-enhanced computed tomography preoperatively revealed a large hydatid cyst measuring 18 cm × 13 cm × 11 cm with few thin septations in the right lobe causing mass effect and splaying of intrahepatic vessels. Intraoperatively, the patient was successfully managed with antihistamines, steroids, crystalloids, and a small dose of vasopressor. After the surgery, she was transferred from the Intensive care unit to the surgical ward on the first postoperative day. The possibility of anaphylactic reactions should be kept in mind, and close monitoring for early diagnosis and appropriate management of anaphylaxis is essential for a favorable perioperative outcome in the case of hydatid cyst surgery.

Uncommon Cause of Pain Abdomen in an End-Stage Renal Disease Patient on Hemodialysis

Abstract Pain abdomen is an unusual symptom in an end-stage renal disease (ESRD) patient, and the causes of the same have not been clearly defined. The causes may be related to advanced azotemia causing esophagitis, gastritis, and peptic ulcer disease or pressure-related pain due to polycystic kidney disease. The causes may be totally unrelated to chronic kidney disease (CKD) and may present due to surgical causes such as cholelithiasis, appendicitis, diverticulitis, acute mesenteric ischemia, and others. We report an unusual case of pain abdomen in an 11-year-old child of CKD on maintenance hemodialysis (MHD) who presented with recent onset left-sided hypochondriac pain and swelling. His contrast-enhanced computed tomography abdomen showed a large hydatid cyst in the spleen, and the patient underwent partial cystectomy for the same. Histopathological examination confirmed the diagnosis of splenic hydatid cyst. The postoperative course was uneventful. There are only a few case reports of isolated splenic hydatid cyst reported from India, but to the best of our knowledge, the same has never been reported in a child with CKD on MHD making it an unusual cause of pain abdomen in ESRD patients.

Hydatid Cyst Pleural and Pericardial Effusions as a Complication of Postoperative Hydatid Cyst Resection from the Liver: A Case Report

Hydatid cyst is a zoonotic endemic disease in Iraq. It carries considerable complications eitherrelated to the disease itself or following its surgical removal. Pleural and pericardial effusion isa rare postoperative complication of hydatid cyst removal. A 65year-old Iraqi female patientcomplained of right-sided chest heaviness and palpitation one month following surgical removal of2 large hydatid cysts. There were no other associated symptoms. Physical examination revealedthe possibility of pleural and pericardial effusions (poor air entry and stony dullness of the rightposterior part of lower zone, difficulty to palpate the apex beat, increase heart dullness, and nopericardial rub). The diagnosis was confirmed by chest X-ray and echocardiogram. She receivedAlbendazole tablet 400 mg twice daily for 6 weeks with a good response. The Early presumptionof the disease in an endemic area with a good dose and appropriate course of Albendazole tabletstreatment can give very good results. To our best knowledge, this is the first case in the worldwho presented with hydatid cyst pleural and pericardial effusions and responded completely to theAlbendazole tablets.

Brown-Séquard syndrome: An uncommon presentation of hydatid cyst

Primary spinal hydatid cyst account for 1% of all cases of hydatid disease. In Indian literature, few cases are reported. We report a case of 27-year-old immunocompetent Indian male patient presenting with brown sequard syndrome like presentation who later was diagnosed with extramedullary intradural multicystic large hydatid cyst. Following surgical removal of hydatid cyst, he was asymptomatic and was discharged on albendazole. There was no relapse in one year follow up. This case is being reported due to its rarity of occurence and presentation.

Hydatid Disease, an Uncommon Etiology of Death in Forensic Practice.

In Tunisia, hydatid cyst is an endemic parasitic disease. The cyst may remain asymptomatic, discovered accidentally, or in case of a complication, the most serious of which is sudden death. We propose, in this article, to analyze the degree of involvement of the cyst in the mechanism of death, through the review of 25 cases. A total of 7932 autopsy cases were performed during the study period. Twenty-five cases of hydatid cyst discovered at autopsy were collected and death was attributed to hydatid cyst in 13 cases. The seat of the cyst was variable and death was due to anaphylaxis in 10 cases, to hydatious embolism in 2 cases and to cardiac arrhythmia, resulting from a cardiac localization of a large hydatid cyst, in 1 case.Although rare, echinococcosis can be a life-threatening disease. Its involvement in the death mechanism remains difficult in many cases.

Anaphylactic shock following minor abdominal trauma as the initial presentation of Echinococcus cyst: a case report

BackgroundAnaphylaxis is a potentially life-threatening condition caused by a variety of triggers. However, anaphylaxis following an abdominal trauma is an exceptionally rare condition and could be the first and only sign of hepatic hydatid cyst, especially when no obvious etiology is present. Here, we present such a rare case and discuss relevant diagnostic and management strategy in light of the literature.Case reportThis case report refers to a 17 year-old previously healthy girl admitted in our pediatric emergency department (ED) for syncope after a minor blunt abdominal trauma. She was hypotensive on admission and shortly after she developed urticaria and angioedema. She was diagnosed with anaphylaxis and treated immediately. Possible etiologies including drug or food ingestion, insect bite, and previous allergy/anaphylaxis history were excluded. After stabilization abdominal imaging was performed, which revealed a ruptured large hepatic hydatid cyst in the vicinity of biliary tree. Albendazole treatment was started and surgical resection was performed after clinical stabilization, which confirmed the cyst rupture into the biliary ducts. Patient recovered without complications after surgery and was discharged uneventfully.ConclusionThis case report highlights that hydatid cyst rupture should be included in the differential diagnosis of anaphylaxis without obvious etiology, particularly in regions where hydatid disease is endemic. Ruptured hydatid cyst leading to anaphylaxis requires timely diagnosis, management and emergent intervention.

Serofibrinous pleural effusion revealing a large hydatid cyst of the liver

Hydatid cyst of the liver remains a serious public health problem in Morocco. It is frequently endemic due to poor environmental sanitation. This benign affection can sometimes cause fatal complications, such as the intrathoracic rupture of a cyst. This is a case of a huge liver hydatid cyst, revealed by serofibrous pleurisy, which is an extremely rare condition. A 9-year-old boy, with no past medical history, was presented to the emergency department for respiratory distress, cough, and right chest pain. The pain was insidious, onset, and progressive. There was no history of fever, hemoptysis or vomica. Physical examination revealed diminished respiratory sounds, with dullness to percussion at the right lung, along-with tenderness in the right hypochondrium area. Chest X-ray film confirmed the presence of right-sided pleural effusion. Thoracoabdominal computed tomography (CT) scan was performed, and it shows a large hydatid cyst of segment VIII of the liver with a huge pleural effusion with no lung lesion. A thoracentesis revealed a yellow fluid. The hydatid cyst was treated by laparotomy and partial excision of the cyst, the diaphragmatic fistula was closed, and the pleural effusion was treated by pleural drainage. After 2 weeks, a chest X-ray showed an encysted pleural effusion, which was later treated by thoracotomy and lung decorticating.

A Giant Pulmonary Hydatid Cyst in a 13-Year-Old Child: A Case Report

: Hydatid disease has been introduced as a crucial health issue in the Eastern Mediterranean by the World Health Organization. Surgery is the standard gold treatment for hydatid disease. Here, we reported a case of a large hydatid cyst involving the lung in a 13-year-old girl complaining of shortness of breath and cough for 8 months. Early symptoms include fever, cough, and shortness of breath. After admission, computed tomography verified giant lung hydatid cysts. Complete collapse of the right lung and progressive respiratory distress of the patient were treated with thoracotomy considering the size of the hydatid cyst in the lung. It should be noted that in such patients, the preservation of lung tissue function is very significant, and also, the less part of the lung is removed after surgery, the fewer complications the patient will suffer.

Giant Hepatic Hydatid Cyst with Retroperitoneal Development—Management of Liver Hydatidosis

(1) Background: Infection with Echinococcus granulosus is the cause of hydatid cysts located frequently in the liver and lungs, but also in the kidneys, bones, spleen, brain and muscles. Cystic echinococcosis is sometimes complicated to treat, requiring radical surgery and prolonged medication. The hydatid cyst in the retroperitoneal space is frequently asymptomatic, unless it grows and produces symptoms caused by high intracystic pressure, secondary infection, wall breaking and allergy. (2) Case Report: We present the case of a 47-year old male patient, admitted for a giant bilobed retroperitoneal hydatid cyst. Following diagnosis, the patient was operated on using an anterior midline abdominal approach. The cyst was inactivated, the contents were evacuated and the cavity was drained and cleaned by opening the cyst in the middle area and at its lower pole, respectively. Subsequently, the cyst required re-installation of the drain. The evolution of the case was finally favorable but confirmed that the postoperative evolution of large hydatid cysts can be unexpected and even followed by complications. (3) Conclusions: For the presented case, the classic surgical method was the appropriate choice, considering the large size of the hydatid cyst. Bilobed cysts and those with calcified walls may cause problems with the spontaneous closing of the remaining cavity. For complicated cysts, the treatment is radical or conservative surgery, while for uncomplicated cysts, minimally invasive treatment is an appropriate choice.

Roux En Y drainage of a large hepatic hydatid cyst as treatment for recalcitrant bile leak: a case report

BackgroundHydatid disease is relatively uncommon in children and thus rarely reported in literature. Pediatric patients with large hydatid cysts can have grave complications due to mass effect. Postoperative bile leak is the most common morbidity and continues to be a challenge for the treating surgeon.Case presentationA 7-year-old boy diagnosed with a giant hydatid cyst of the liver, almost replacing the right lobe, and underwent a laparotomy and excision of cyst with tube drainage. He developed postoperative major bile leak which did not subside even after a redo laparotomy and closure of the suspected bile leak areas. The child underwent a third laparotomy after a hepatobiliary scintigraphy (HIDA scan) which confirmed a persisting major leak. A Roux En Y cystojejunostomy was done this time which drained the bile adequately postoperatively with no evidence of bile in the subhepatic drain. Oral feeds were resumed on the fifth postoperative day. He was discharged in a satisfactory condition and is doing well in the follow-up. Repeat HIDA scan showed no evidence of spillage, with adequate bilio-enteric drainage.ConclusionPersistent major bile leak requiring ERCP with sphincterotomy can be managed successfully in children by internal drainage as Roux En Y cystojejunostomy.

A rare location of primary extrahepatic hydatid cyst in the soft tissue

Hydatid cyst or cystic echinococcosis in human is rare disease caused by tapeworm Echinococcus granulosa. Hydatid cyst of soft tissue is a rare condition and we had a case of large hydatid cyst in lumbar region. This is a case of 48 years old female presented to us during October 2018 with a large diffuse swelling over the left lumbar region which was gradually grown over the last 2 years without pain. The diagnosis of hydatid cyst was not sure even in CT scan but it was in our differential diagnosis. It is confirmed during surgery after seen the multiple cyst removed from the large cystic lesion. No recurrence even after 15 months of follow up. Presence of hydatid cyst in soft tissue is usually rare and its diagnosis is not expected clinically when it presents as a soft tissue swelling. We need to confirm it during surgery or by presence of typical germinal membrane under microscope.

Cardiac Hydatid Cyst

A 52-year-old female presented with features suggestive of acute coronary syndrome. A transthoracic echocardiogram done to assess the cardiac function and regional wall motion abnormality revealed a large cardiac cystic lesion instead, in the apical part of the interventricular septum, suggestive of a hydatid cyst. Cystic hydatid disease results from infection with the larval or adult form of the Echinococcus granulosus tapeworm. Cardiac hydatid cyst is a rare condition seen in 0.5%–2% of patients with hydatid disease, and the location of a hydatid cyst in the interventricular septum is exceptional. Cardiac hydatid cysts can rupture and cause cardiac tamponade, fatal arrhythmias, or systemic infection. The atypical location of a large hydatid cyst in the apical interventricular septum encroaching into the right ventricular cavity filling almost half of it, was an interesting finding, found worth reporting. Also, further investigations that unraveled two more hydatid cysts in the liver, made the case more interesting to report.

Cystocholecystostomy: A new technique for management of hilar biliary disruption due to a large hydatid cyst liver - Ten years of follow-up

A long-standing and large-sized hepatic hydatid cyst located at the liver hilum is likely to rupture into the adjoining major bile ducts. This unusual complication demands preoperative diagnosis at an early stage and adequate surgical management so as to prevent morbidity and mortality. Such cases are managed with bilioenteric anastomosis by doing Roux-en-Y cystojejunostomy. However, one such case was managed by performing side to side anastomosis between disrupted hydatid cyst at the hilum and adjoining gallbladder. This innovative surgical procedure was named “Cysto-cholecystostomy” and was reported for the first time in the English literature. This case report presents ten years of follow up of this patient along with discussion of related cases published in the literature.