Wednesday, December 18, 2013

What is Hydatid cyst? Investigations and treatment.

Hydatid cyst

Hydatid cyst is a very common cystic disease of liver, in the people of the subcontinent. This disease is most common among the people of India, Bangladesh, Nepal and Myanmar. This is a parasitic disease. And the causative organism is Echinococcus granulosus.
Hydatid cyst

Structure of Hydatid cyst:

The cyst is composed of three layers. They are;
1.       An outer layer derived from the host.
2.       An intermediate laminated layer.
3.       An inner germinal layer.
Feature of the cyst:
1.       They can be single or multiple.
2.       Chronic cysts become calcified.
3.       The cyst may be asymptomatic but may present with abdominal pain or mass.
4.       Rupture or secondary infection of the cyst can occur and a communication with the intrahepatic biliary tree can then result with associated biliary obstruction.

Investigations:

1.       Complete blood count.
2.       Peripheral blood film.
3.       USG of the whole abdomen.
4.       CT scan of the abdomen.
5.       Echinococcus ELISA has 90% sensitivity for hepatic hydatid cyst.

Treatment of Hydatid cyst:

1.       Medically with albendazol or mebendazol prior to definitive therapy.
2.       In the absence of communication with the biliary tree, treatment consists of PAIR therapy. (PA= Percutanious aspiration of the cyst; I= Injection of 100% alcohol into the cyst; R= Re aspiration of the cyst contents)

3.       When there is communication between the cyst and the biliary tree then surgical remobal of the cyst is done. Ablendazol for 14 days is given to the patient. Before the surgical intervention and after the surgery. 

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