Dr Arthur Richardson - Hepato-Biliary, Upper Gastro-Intestinal and General Surgeon Associate Professor,University of Sydney
 
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Hydatid Liver Disease

The liver is the most frequent site of hydatid cysts. Most hydatid liver cysts caused by the parasite E. granulosus are multiple and localised in the right lobe.

The infection is transmitted from animals to humans. If found in humans, the hydatid disease presents a serious problem.

The hydatid liver cyst can rupture spontaneously into the bile duct system, expelling the contents of the cyst into the bile ducts, and causing obstructive jaundice. The cyst can also rupture into the free peritoneal space following trauma or even a small blow to the abdomen. Large cysts, situated close to the liver hilum, can compress the main bile ducts and the vessels, causing obstructive jaundice or lobar atrophy or portal hypertension. The infiltrative process can involve large portions of the liver and cause stenosis of intrahepatic bile ducts and hepatic and portal veins.

Diagnoses

Apart from clinical history and blood tests, diagnosis may involve an ultrasound, a CT scan or an MRI

Treatment

The treatment of hydatid cyst involves surgical enucleation of the cyst and perioperative medical treatment with albendazole

Newer modality of diagnosis and treatment involves percutaneous drainage of the hepatic hydatid cyst under CT/USG guidance

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