Management of hepatic and intracardiac echinococcal cysts: case report and review of the literature.
BACKGROUND
Infection with Echinococcus granulosus affects the liver commonly, but disseminated involvement is rare. We describe a 63 year-old man with echinococcal infection producing both hepatic and cardiac involvement that was managed surgically after failed percutaneous hepatic treatment.


METHODS
This report is a case study of a unique surgical problem. Various treatment modalities are reviewed.


RESULTS
The patient was a 63 year-old man from Iraq who immigrated to the United States after becoming infected with Echinococcus granulosus. He had undergone percutaneous management and albendazole therapy prior to presentation for treatment of hepatic hydatid cysts. He continued to have abdominal pain and fever and was referred to our institution. Imaging revealed persistence of the hepatic hydatid cysts, as well as a new finding of an intracardiac hydatid cyst. The patient underwent successful treatment of his complicated hepatic hydatid cysts with pericystectomy and repair of a biliary fistula. The cardiac cyst was removed as well. The patient made an uneventful recovery, and his symptoms resolved.


CONCLUSIONS
Although rare, echinococcal infection may be encountered in the United States as travel increases to and from regions of the world where the disease is endemic. It is important for surgeons to be familiar with the multiple options for treatment of hydatid disease.
Bell
Christopher
C
Department of Surgery, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, 75208, USA.
Yorgason
Joshua
J
Jessen
Michael E
ME
Josephs
Shellie
S
Jain
Tulika
T
Jeyarajah
D Rohan
DR
D004443:Echinococcosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000601:surgery; D048209:Echinococcus granulosus; D006321:Heart / Q000469:parasitology; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000469:parasitology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed