Percutaneous management of liver hydatid cyst causing obstructive jaundice

ABSTRACT

Surgical treatment for liver hydatid cyst has been considered so far as standard therapy, but has a high recurrence rate as well as morbidity and mortality. We report a case of a 30-year-old Saudi male who presented with obstructive jaundice, secondary to a huge hydatid cyst of the liver of about 20 cm diameter. The cyst was compressing the right lobe of the liver and biliary tree causing the obstructive jaundice. There was no evidence for rupture of the cyst into the biliary tree; CT-guided percutaneous aspiration and drainage of the cyst was performed successfully. This was followed by irrigation of the cyst with hypertonic saline via retained intracystic pigtail catheters. Within the first 2 weeks the jaundice was resolved. Combined medical therapy of albendazole and praziquantel was also administered. The patient showed clear clinical improvement during regular follow-up. His repeated CT 4 months later showed disappearance of daughter cysts.The case illustrates the possibility of avoiding surgical management and it illustrates the successful percutaneous management of such a large hydatid cyst causing obstructing jaundice