Challenges in Management of Hydatid Cyst

Abstract

A 35-year-old male presented to the outpatient department with dull aching right hypochondrial pain for 10 days, which was associated with fever & chills. On examination, the patient was febrile, icteric with tender hepatomegaly. Total leukocyte count and liver function test were raised. Serum bilirubin was elevated. USG abdomen showed 5x6x6cm, heterogenous, hypoechoiec lesion with internal cystic areas with peripheral calcification in right lobe. Cect abdomen (Figure 1a) showed daughter vesicles and MRI was suggestive of hydatid cyst. Patient underwent laparotomy wherein calcified hard cyst in the 5th & 6th segment of right lobe was found. Cyst fluid and daughter cysts were evacuated (Figure 1b) and 5% povidone iodine was instilled into cyst cavity for about 10min. Cpapitonnage was done by obliterating cyst space with vascularised omentum. Post op was uneventful. Patient was followed up for six months and it was uneventful.