Different presentations of hydatid cyst and its management – A prospective and observational study in a tertiary care hospital in Kolkata

Abstract

Background: Hydatid disease of liver is quite common disease in Eastern India, though not very frequently reported. The diagnosis of hydatid cyst is often difficult because of its initial modes of presentation. Aims and Objectives: The objectives of the present study were to evaluate the different clinical presentation, surgical management options, and complications if any after operation in a tertiary care center. Materials and Methods: This prospective study was conducted with 30 patients (Male 17 and Female 13 with a mean age of 41.23 years) who were diagnosed of having hydatid cyst of liver. Results: The presenting symptoms that were found pain abdomen (22 cases), abdominal lump/mass (16 cases), cholangitis (five cases), jaundice (two cases), constitutional (anorexia, nausea, and malaise two cases), and fever (18 cases). Deroofing and omentoplasty and wound drainage (12 cases), partial pericystectomy (nine cases), pericystic-cystectomy (six cases), marsupialization (two cases), and one case was managed nonoperatively. Post-operative complications were – biliary fistula (two cases), post-operative cholangitis (two cases), surgical site infections (two cases), and retained cyst (one case). Conclusion: A high index of suspicion is always recommended when an adult patient comes with pain abdomen and abdominal mass. Different surgical methods, for example, deroofing and omentoplasty with wound drainage, partial pericystectomy, and pericystic-cystectomy can be applied. To establish the definite surgical management, many more randomized and controlled studies are needed.

Keywords

• cystic echinococcosis; echinococcus granulosus; surgical techniques