The Adventitia Resection in Treatment of Liver Hydatid Cyst: A Case Report of a 15-Year-Old Boy

Human hydatid disease is a significant health problem in endemic regions caused by the larval form of Echinococcus granulosus. In this paper, we report a case of liver hydatid cyst. The patient, a 15-year-old boy, presented with a history of intermittent upper abdominal pain of a few-month duration was referred to our hospital for investigation. Computed tomographic scan and laboratory test suggested a hydatid cyst in the right lobe of liver. The adventitia resection of hydatid cyst was smoothly performed as there was a less bloody virtual space between adventitia and outer membrane. Our diagnosis was made using an imaging approach and was confirmed during surgery. We proposed the adventitia resection of hydatid cyst could be safe and easy to perform with low risk of bleeding and bile leakage. 1. Introduction Human hydatid disease, caused by the larval form of Echinococcus granulosus, is a significant health problem in endemic regions, especially in the Mediterranean countries, the Middle and Far East, Europe, Asia, South America, and Australia [1]. Incidental infestation leads to cyst formation in the liver. The most frequent complications of this severe disease include those related to the compression of adjacent organs or to perforation into the biliary system and pleural cavity or even to cyst infection [2]. Surgery is currently the primary treatment. It can be performed through laparoscopy or laparotomy. Radical surgical management of hepatic hydatid cysts includes ranges from aspiration of the parasite (or hydatid) to the excision of the cyst. The aim of the surgery is the total removal of the cysts without rupture since this can cause spillage of live scolices and anaphylaxis. The purpose of continuous improvement of the surgical method is to reduce the complication and to shorten the treatment period [3]. To achieve more effective evacuation of the cavity, we present the case of the adventitia resection. 2. Case Report The patient was a 15-year-old boy and presented with intermittent upper abdominal pain of a few-month duration. He described long-term rural life history and contacted with animals such as dog, cattle, and sheep. Upper abdominal CT indicated that the right lobe of liver had a large low-density lesion, suggesting liver hydatid cyst (Figure 1). Casoni test gave a positive reaction. Under general anesthesia, the adventitia resection of liver hydatid cyst was performed. The lesion was characterized by a 20 × 18 × 15？cm3 cystic mass in segments VII-VIII with fibrous membrane (Figure 2). A 12-French scale (Fr) percutaneous transhepatic