LIVER HYDATID CYST

1
LIVER HYDATID CYST
2
CLASSIFICATION OF HYDATID CYSTS

• PRIMARY CYSTS
• MULTIVESICULAR OR SECONDARY CYSTS
• SECONDARY ABDOMINAL IMPLANTATION

3
Natural history of liver hydatid

• 1 - Development of cyst biliary
  communications
• 2 - Intrabiliary rupture
• 3 - Intraabdominal rupture
• 4 - Intrathoracic rupture
• 5 - Intrathoracic rupture
• 6 - Cyst death

4
(No Transcript)
5
CLINICAL FEATURES

• 1 Symptomless
• 2 Painful or painless hepatomegaly
• 3- Abdominal mass
• 4-Jaundice
• 5 - Intraperitoneal rupture

6
DIAGNOSTIC STUDIES

• Serological tests
• Imaging techniques
• 1 Ultrasonography
• 2 CT scan
• 3 MRI
• 4 ERCP

7
(No Transcript)
8
TREATMENT

• Medical treatment
• bebzimidazole group
• Praziquantel

9
Indications of medical treatment

• 1 Inoperable cases
• - Site
• - Multiple cysts
• 2 Concomitant diseases

10
Contraindications

• 1 Pregnancy or lactation .
• 2 Heavily calcified cysts .
• 3 large cysts .
• 4 Obstructive jaundice .

11
Surgical treatment

• Objectives
• Remove all living cyst elements .
• Prevent spillage .
• Close biliary communications .
• Sterilize cavity .

12
Scolicidal agents

• 1- Hypertonic saline ( 3 ) .
• 2- Hydrogen peroxide 6 .
• 3- Citeramide .
• 4- Silver nitrate 0.5 .
• 5- Rectified spirit ( 96 ) .
• 6- Formalin

13
Intrabiliary rupture

• Operative cholangiogram .
• Bile duct exploration .
• T tube insertion .
• Choledochoscopy .

14
Residual cavity management

• (1) Suture any obvious small bile duct openings
• (2) Fill it with ordinary 0.9 saline
• (3) Saucerize it by excising the protruding
  portion
• (4) Fill it with a graft of omentum.
• (5) Stitch the walls of the cyst