ABSTRACT
Primary hydatid cyst of the pancreas is rare, representing 0.2-2% of all human cases. It is usually single and located in the head of the pancreas. The aim of this study was to describe clinical, radiological and therapeutic aspects of hydatid cysts of the pancreas. This study was carried out in the Department of Digestive and General Surgery in Sahloul University Hospital, Sousse in Tunisia during the period 1993-2009. Seven patients were treated for hydatid cyst of the pancreas, three men and four women with an average age of 30 years. The clinical signs were variable according to size and location of the cyst within the pancreas and the degree of biliopancreatic involvement. The main symptoms were pain in left upper quadrant, jaundice, fever and epigastric and right upper quadrant pain. The preoperative diagnosis was established in six patients by ultrasonography and computed tomography [CT]. However, the diagnosis was established during laparotomy in one case. The echinococcal immunological test [ELISA] was positive in only two cases. Surgical treatment included resection of the prominent lump [cystectomy] in five cases, and distal pancreatectomy with splenic preservation in one case and with splenectomy in one case. The postoperative period was uneventful in six cases. Acute postoperative pancreatitis occurred in one case. The patients were free of symptoms and were followed up for 12 months without any recurrence as revealed by abdominal ultrasonography and CT scan. Hydatid cysts in the pancreas are rare. Even if rare, these should be considered in the differential diagnosis of cystic lesions of the pancreas. The surgical treatment is to be considered whenever possible