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.
There are four types of echinococcosis:
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
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
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.
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.
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.