Percutaneous Aspiration-Injection-Reaspiration of Hepatic Cystic Echinococcosis

Abstract

Human echinococcosis is a zoonotic infection caused by larval forms (metacestodes)of the tapeworm of the genus echinococcus found in the small intestines of carnivores. Humans are only incidentally infected. The liver is the most frequent site for the cystic lesions seen in hydatid disease, followed by the lung, the brain, and other visceral. Surgery is the recommended treatment for hepatic hydatid cysts. However, drug therapy and percutaneousdrainage have recently been introduced as alternative treatments. We present the case of a 68 year old female pacient that admitted in our clinic for pain in the superior abdominal region. The ecography performed revealed a large cystic formation about 700 mL with a diameter of 10 cm in the right lobe of the liver. We performed a Percutaneous Aspiration-Injection-Reaspiration Drainage (PAIR) under Albendazol treatment before and after the procedure without any incidents. The histopathological examination concluded the diagnosis of hydatid hepatic cyst. Percutaneous drainage is minimally invasive and very effective in the treatment of hepatic hydatidosis. Percutaneous aspiration of a documented or suspected hydatid cyst was long considered to be contraindicated to avoid the risk of leakage of cyst contents, which can lead to anaphylaxis and seeding of intraperitoneal structures. In the our case report the hydatid hepatic cyst was a large univezicular cyst, with a approachable localization in the liver, on a pacient without any other medical problems that was suitable for PAIR, and after the procedure we didn�t identified any of the complication reported in literature. The effectiveness of PAIR method allowed a short period of hospitalization with ambulatory follow up with benefits on the both sides , the pacient social integration and medical system economy.