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Hyatid cyst

Hyatid cysts are a result of parasitic infestation caused by the genus Echinococcus which is a tapeworm. They remain asymptomatic even after they have advanced. The degree of symptoms depend on the size of the cysts, the site and the load of the parasite.

Types

There are four types of echinococcosis:

Cystic echinococcosis or CE: this is extremely common in endemic areas and is caused due to E. granulosus

Alveolar echinococcosis or AE: also very common and spreads due to E.multilocularis

Polycystic echinococcosis: results due to E. vogeli

Unicystic echinococcosis: infection of E. oligarthrus

Causes

Larval cestodes of phylum Platyhelminthes or tapeworms

Poor hygiene in animal and personal

Feeding dogs raw offal

Regular contact with dogs

Ingestion of under-cooked pork meat

Signs and symptoms

Hyatid cysts in the liver Is usually asymptomatic. In advanced stages or if complications develop, it can be symptomatic. Reveal jaundice, abdominal pain and palpable mass; rupture of the cysts in the liver will spill contents into the bile duct and peritoneal cavity and lungs causing uritcaria, fever and anaphylactic reactions

Diagnosis

Physical examination:

Jaundiced skin

Urticaria

Erythema

Spider angiomas indicative of cirrhosis of the liver

Vital signs hypotension with anaphylaxis due to cyst leak

Lungs airway obstruction, decreased breath sounds

Abdomen tender hepatomegaly, abdominal tenderness, ascites, splenomegaly

Blood tests: indirect hemagglutination test and enzyme-linked immunosorbent assay or ELISA. This is commonly known as hydatid serology.

Imaging studies:

Ultrasound

CT scan

MRI

Ultrasound and CT scan tests are usually diagnostic of hydatid cysts. These also helps to characterize and delineates the exact anatomical location of the cyst before surgery.

Treatment

In case of cystic echinococcosis, if liver cysts are large, superficially located and single, they have a chance to rupture. A total pericystectomy or partial resection of the affected organ is indicated. Liver hydatid cysts can often be tackled with laparoscopy. Surgery is undertaken after a course of medical therapy. Meticulous and careful surgical intervention is needed to avoid and prevent spillage of the fluid into the abdomen. Inadvertent surgery can cause spread of the disease in the abdomen.

Dr. Deepak Varma and his team are adept at handling both cases of AE and CE very effectively.