Primary hydatid disease of the gallbladder: a rare clinical entity

Abstract

Hydatid disease is endemic in Greece, and has been known from Hippocrates' time to cause cysts in the liver. We report here three very rare cases of primary gallbladder hydatid disease without prior history or evidence of concurrent disease activity in any other location. To our knowledge, only two previous reports exist, each of one patient suffering from primary gallbladder hydatid disease. Unlike the insidious hydatid cysts of the liver, gallbladder hydatidosis in our patients was associated with early diagnosis, due to gallbladder dysfunction symptoms presenting early in its course. Moreover, the size of gallbladder cysts compared to liver cysts at diagnosis was small (maximal diameter, <5 cm), making total cyst excision along with cholecystectomy feasible for all of our patients. During long-term follow up of the patients (up to 10 years), no disease recurrences were noted. We provide supporting evidence that primary gallbladder hydatidosis presents a different pathophysiological and clinical course, having better prognosis, when compared with the usual liver disease.

Primary hydatid cyst of gallbladder: A case report

“…Human beings are secondary dead end (asexual cycle) host [1][2][3][4][5]. Human infection is caused by fecal-oral route or ingestion of contaminated vegetables or meat [1][2][3][4][5][6][7][8][9]. Cystic transformation of Echinococcus granulosus in human organs results in varied symptoms.…”

“…Liver (first filter) and Lungs (second filter) are the commonest organs involved worldwide. In children, due to unknown cause lung infection (41-70%) is more common than liver (42-48%) [5][6][7]. Other organs are involved secondary to pulmonary or hepatic involvement.…”

“…Other organs are involved secondary to pulmonary or hepatic involvement. Among the unusual primary sites, in order of frequency, central nervous system (4-5%), musculoskeletal system (0.5-4%) and cardiovascular system (0.5-2%) are involved [2,5,6,9].…”

“…Gallbladder is primarily involved in 0.6%. GB cysts may be located intraluminally or on the surface [1][2][3][4][5][6][7][8][9]. As a rule luminal cysts are single and parietal cysts are multiple containing daughter cyst [2,5].…”

“…The incidence of primary extrahepatic intra abdominal hydatid cyst is 6.5% [1][2][3][4][5][6][7][8][9]. Spleen (2-3%) is the predominant organ involved [1,[3][4][5].…”