review on hydatid cyst of liver, with a brief report of 126 cases from Fars province

ABSTRACT

A retrospective review of 126 surgically-proven cases of hydatid cyst of the liver was performed. Sixty percent of the patients were in the third and fourth decades of life. The most common presenting complaint was right upper abdominal pain and/or fullness sensation [92%]. Duration of symptoms was more than two months in 61%. One third of the patients had more than one cyst in the liver. Cysts were located in the right lobe in 68%, left lobe in 19% and both lobes in 13%. In 6%, other intra abdominal cysts were found during surgery. Cysts were infected in 29% and were complicated by rupture or fistula formation in 10%. Chest x-rays were abnormal in 37% [elevated right hemidiaphragm, 22%; right lower lobe infiltrate/atelectasis, 5%; right pleural effusion, 13%; pulmonary hydatid cyst, 7%]. Plain abdominal films were abnormal in 41% [curvilinear calcification, 22.5%; hepatomegaly, 24%; splenomegaly, 5%; air fluid level in the liver cyst, 2.5%]. Upper gastrointestinal barium studies showed extrinsic pressure on the stomach and duodenum in 40%. Liver scintigraphy was abnormal in 96%, but in 25% there was a discrepancy either in number or location of the cyst[s] when compared to surgical findings. Angiography was abnormal in all the cases performed. Literature on pathophysiology, radiologic findings [including CT scan and ultrasonography], and on surgical and medical therapy of hydatid disease of the liver is reviewed