Various Presentations of Hepatic Hydatid Cystic Disease and their Management

Abstract

Introduction Hydatidosis, a zoonotic infection, is due to the larval stage of the tapeworm Echinococcus (E.). Two of the recognised species, E. granulosus and E. multilocularis, are of importance for humans. The disease has a world-wide distribution. Biological diagnosis relies on serological tests. CT-scan of abdomen and chest, while not usually essential for diagnosis, gives a better definition of cysts content, number, size and calcification together with relation to vessels or other organs. With this information this study aims to analyze the different clinical presentations, complications and available various management options available for hydatid cyst of liver. Method & Materials This is a prospective observational study of 30 patients with hydatid cyst of liver included the patients admitted in the Department of General Surgery, L.L.R.M. Medical College, Meerut and S.V.B.P. Hospital, Meerut between jan 2018 to august 2018. All patients of either sex, male or female admitted with the diagnosis of hepatic hydatid cyst. There were no exclusion criteria. The data was analyzed by SPSS 21.0 version. Result In our series we analysed 30 patients. M:F ratio was 1.3:1. Most commonly involved age group was 40–49 yrs. Pain abdomen was the most common presenting symptom seen in 22 patients. Hepatomegaly was seen in 22 patients, Jaundice seen in 16 patients. Right lobe of liver was involve in 20 patients while both lobes were involved in 10 patients. Isolated left lobe involvement was not seen.ELISA for Echinococcal Antibody was performed in all 30 patients. Sensitivity was 100% while specificity was 99%. Deroofing with omentoplasty and wound drainage was the most commonly performed procedure and was performed in 12 patients Concluson This study was conducted to highlight the different modes of presentations of hydatid cyst of liver and effective management techniques. For symptomatic hydatid cyst of liver, open surgical approach is the best modality of management. Although majority of patients were treated surgically, importance of antihelminthics chemotherapy pre and post operatively is immense. As there are less number of patients presented in our study this data can be meta analyzed in other higher institutions.