Chapter 51: Liver- Hydatid Liver Cyst Flashcards
What is it?
Usually a right lobe cyst filled with Echinococcus granulosus
What are the risk factors?
- Travel
- exposure to (carriers):
- dogs
- sheep
- cattle
What are the signs/symptoms?
RUQ abdominal pain
jaundice
RUQ mass
How is the diagnosis made?
- Indirect hemagglutination antibody test (serologic testing)
- Casoni skin test
- ultrasound
- CT scan
- radiographic imaging
What are the findings on AXR?
Possible calcified outline of cyst
What are the major risks?
Erosion into the pleural cavity pericardial sac, or biliary tree
Rupture into the peritoneal cavity causing fatal anaphylaxis
What is the risk of surgical removal of echinococcal (hydatid)cysts?
Rupture or leakage of cyst contents into the abdomen may cause a fatal anaphylactic reaction
When should percutaneous drainage be performed?
Never; may cause leaking into the peritoneal cavity and anaphylaxis
What is the treatment?
Mebendazole, followed by surgical resection;
large cysts can be drained and then injected with toxic irrigant (scoliocide) into the cyst unless aspirate is bilious(which means there is a biliary connection) followed by cyst removal
Which toxic irrigations are used?
Hypertonic saline, ethanol, or cetrimide