Giant Liver Hydatid Cyst: A Case Report and Review of the Literature.

Cystic echinococcosis (CE) is a parasitic disease caused by the larval stages of Echinococcus and is considered a neglected disease of public health worldwide. CE primarily affects the liver and demonstrates distinctive radiological findings in computed tomography (CT) and ultrasonography (US). Surgery is considered the mainstay of CE treatment. The patient was a 17-year-old man admitted to the Emergency Department of Shahid Faghihi Hospital affiliated with Shiraz University of Medical Sciences with dull right upper quadrant abdominal pain, loss of appetite, abdominal distention, and fullness. An abdominal CT scan revealed a giant hepatic cyst measuring about 24x20x15 cm in the right hepatic lobe (RHL) with a pressure effect on the right kidney, pancreas, and bowel loops. Semi-chevron incision was done and the patient underwent partial precystectomy with capitonnage and omentoplasty. The surgical outcome was uneventful and the patient was discharged on the eighth day after the surgery with the oral Albendazole. Reviewing the literature, our case was the 5th rank according to the size of the recorded published cases. The most common countries where the largest liver hydatid cysts were reported were Greece and Turkey. The most common surgery was the open surgery and the most common incisions were Kocher and then Chevron incisions. When dealing with a huge liver cyst, a high index of suspicion for echinococcal etiology becomes important in endemic areas such as Iran. The choice of treatment for giant hepatic cysts substantially seems to be radical surgery by surgical ablation in general to mitigate the mortality and morbidity rate, because they are at risk of rupture, anaphylaxis, and so forth. (The abstract is too long for a case report [260 words], it should be around 100 words. The part I highlighted can be deleted.) [ABSTRACT FROM AUTHOR]