Cover image for the Hydatid Cyst of the Liver article

Watery cyst in the liver and the process of eradicating it

A hydatid cyst in the liver is a parasitic disease in which a hydatid cyst or a group of cysts forms on the liver accompanied by some symptoms. The treatment of liver and lung cysts is by surgical removal in Turkey.

Infection with the Echinococcus granulosa worm leads to a disease, which is echinococcosis or so-called Liver cyst with Echinococcus granulomatosis, which is often a collection of liquid in the cysts that are present in the lungs and liver or one of them; these cysts are filled with fluids, and inside them are germinal cysts that lead to the formation of hydatid sand inside the liquid when it is separated from the cyst, the hydatid cyst in the liver is characterized by its slow growth.

In this article, learn about the hydrocele cysts that affect the liver, the reasons for their appearance, and all the details related to their treatment and the process of eradicating them in Turkey.

What are hydatid cysts?

Hydatid cysts hydatid cysts It is a disease caused by the echinococcus granulosus worm that infects humans due to eating food contaminated with eggs. The eggs hatch inside the human body, go to several organs, including the liver, and form hydatid liver cysts.

A graphic image of a hydatid cyst in the liver with cysts and liquid inside
We notice the presence of a hydatid cyst inside the liver, and inside it are germinal cysts and fluid, with the presence of the double envelope

The organ most susceptible to infection is the liver 63%, followed by the lung 25%, then the muscles 5%, the bones 3%, the kidneys 2%, the brain 1%, the spleen 1%, and the uterus one of the rare cases.

The life cycle of the Echinococcus granulosus worm

  • The adult worm is present in the intestine of the definitive host (the dog).
  • Echinococcus eggs are expelled with the feces of the definitive host. They are immediately infectious by eating vegetables contaminated with these eggs.
  • The worm enters the intestines of the intermediate host (for example, human) and hatches to give a larva with thorns that penetrates the human intestine.
  • The larva travels through the blood and forms hydatid cysts in one of the body's organs, thus forming a hydatid cyst in the liver (it often affects the liver and lungs).

When the definitive host eats the liver of the intermediate host infected with a hydatid cyst, the primary worm enters the intestine and attaches to the digestive tract, then develops into a mature worm in the intestine. Still, in the definitive host, it does not lead to a hydatid cyst in the liver.

Diagram showing the life cycle of the Echinococcus granulosus worm
Image showing the method of transmission of the parasite between humans and dogs

Reasons for the appearance of a hydatid cyst in the liver

Ingestion of food and water contaminated with the eggs of the Echinococcus parasite leads to infection and the formation of the disease Cysts on the liver Most often, because of this mode of transmission, echinococcosis is not contagious by human-to-human contact.

But if the fluid inside the hydatid cyst in the liver leaks along with the germinal cyst, it can grow in any place it has reached and lead to the formation of new cysts.

Symptoms of a hydatid cyst in the liver

Most cysts do not lead to symptoms because the cysts of the granulomatous echinococcus grow slowly and do not lead to symptoms quickly. Still, if the cyst grows, symptoms appear due to pressure on the neighboring organs.

So, in the beginning, when it is small and causes vague symptoms such as fever, a hydatid liver cyst may be painful and may lead to a feeling of flatulence. It can also lead to high pressure in the portal vein if the hydatid sac is close to it, leading to its blockage.

But when the cyst becomes more extensive, it leads to symptoms due to pressure on the neighboring structures. For example, symptoms of a liver cyst may lead to obstructive jaundice and abdominal pain, with a rupture of the bile ducts next to it. The classic triad of bile duct obstruction, consisting of Biliary colic pain, jaundice, and biliary pruritus, was also noted.

However, cysts can also exist in the lungs along with the liver or alone, leading to additional symptoms such as:

  • cough
  • shortness of breath
  • Pleural pain
  • hemoptysis;

Cysts can also be present in the brain, where they can cause symptoms such as:

  • headache
  • dizziness
  • It may cause some other neurological symptoms depending on the affected area

Complications of the hydatid cysts in the liver

The seriousness of hydatid liver cyst Comes in the event of a rupture or bursting of the cyst. In the event of a slight leakage of the contents of the cyst, it may lead to a mild allergic reaction consisting of redness and hives.

However, in the case of a significant rupture or explosion, a complete allergic reaction appears, in which a severe drop in pressure happens and may kill the patient.

Diagnosis of hydatid cysts of the liver

Examination of the body does not show any specific signs, but we can see hepatomegaly or symptoms of dyspnea. Laboratory tests and radiographic methods are Turkey's two most important methods in diagnosing liver cysts.

Laboratory tests

Routine laboratory blood tests are inconclusive in confirming the diagnosis and may show an elevated leukocyte count, often at the expense of eosinophils. They may also reflect liver involvement by elevated bilirubin and alkaline phosphatase values, which are helpful tests.

The indirect hemagglutination test and the enzyme-linked immunosorbent assay (ELISA) have a sensitivity of 80% for echinococcosis (about 90% for liver injury), so they are the primary screening tests.

Casoni test

In the past, parts of the parasite were injected into the skin's dermis, an allergy test for the parasite. The sensitivity of this test was 70%. Still, now this test has been abandoned because of its low sensitivity and accuracy and because it may lead to a severe local allergic reaction.

Radiographic examinations

Among the radiological procedures used to detect a hydatid liver cyst, we mention the following:

Plain films

The plain films of the chest and abdomen are, at best non-diagnostic and do not reveal cysts. The presence of simple calcifications surrounding the tumor may indicate a hydatid cyst, but it is inconclusive. In lung cysts, the chest film may be standard sometimes.

Radiographic criteria:

  • The wall of the hydatid cyst is multilayered
  • The wall of the cyst in the liver is thick and contains some calcifications

Ultrasound imaging

It may help in diagnosing the infection if the doctor sees the cysts in the liver and if he sees hydatid sand. However, the benefit of ultrasound imaging remains limited to the expertise of the radiologist who performs it.

CT scan

The best procedure for diagnosing a hydatid cyst in the liver, its accuracy is up to 98%, and it can detect the germinal cyst inside the hydatid cyst, and it is the best for differentiating them from amoebic cysts and purulent cysts in the liver andfibrosis.

A CT image showing the hydatid cyst in the liver
We notice the presence of the hydatid cyst in the liver with fluid inside it on the CT scan, and we also see the thick covering of the hydatid cyst


MRI shows germinal cysts well but provides no additional benefit than CT.

ERCP imaging of the biliary tract

It provides a diagnostic and therapeutic benefit at the same time, as the doctor inserts the endoscope into the bile ducts to diagnose the cysts in the bile ducts and help treat them in the case of their rupture. But he cannot see if it is in the liver or on the outer surface of the liver.

Image showing hydatid cysts in the bile ducts with ERCP
A hydatid cyst is seen inside the bile duct during the ERCP procedure

Treatment of a hydatid cyst in the liver

There are many methods of treating liver cysts, but the most important method is surgery to remove the cyst in Turkey, as it provides a high recovery rate, and among these methods:

Drug therapy

Small unilateral superficial cysts may respond to antiparasitic drugs, especially albendazole, as it kills the parasite and reduces the size of hepatic cysts.

PAIR technology

It is one of the modern techniques in Turkey and means: puncture, aspiration, insertion and reaspiration.

This technique is done by using a needle or catheter to puncture the watery cyst and withdraw the fluid inside it, then inject a parasite-fighting chemical and leave it for a while and then re-pull it, the doctor repeats this process until it is sure that the cyst is completely emptied, then it is removed and removed.

Surgical treatment in Turkey

Hydatid cystectomy in Turkey is the best option for the treatment of a single large cyst, a mixed cyst (ruptured or fistula with the biliary tree), or one larger than 10 cm in diameter.

Albendazole should be given one week before Excision of a cyst in the liver In Turkey, to reduce the size of liver cysts, to reduce the risk of secondary infection or hypersensitivity in the event of fluid spillage into the abdominal cavity and continues for four weeks postoperatively, the surgical field (covering the liver) should also be protected with hyperosmolity 20% saline, for example.

The cyst must be removed in one go, called the surgical Obstet of hydatid cyst. This is done with great precision for fear of perforation of the hydatid cyst – the Bimaristan Center in Turkey offers the best doctors in this field. If it is difficult to surgically obstet the cyst, the PAIR technique removes it.

An image showing the appearance of the hydatid cyst in the liver after its surgical removal
The appearance of the cyst after surgical removal

Reasons for performing surgery

If the hepatic cyst is large, single, superficially located on the liver, contains many germinal cysts, carries a risk of rupture, is inside the bile ducts, or presses on critical vital organs, it requires surgery to remove it.

Also, cysts on other organs, such as the brain, kidneys, and others, require surgery to remove them. The surgical work is done by a medical team led by a general surgeon. The doctor may prefer to combine these methods to eliminate the hydatid liver cyst.

Follow-up after surgery

Echinococcosis is a recurrent disease; It reappears after several years of treatment, so it is preferable to follow up through imaging procedures, such as ultrasound of the liver or computed tomography, for up to three or five years to ensure the safety of the body.

Treating hydatid cysts with herbs

Many parasitic and bacterial diseases are treated with herbs; some have shown a good effect on parasites. However, some research is still being done in laboratories for Echinococcus granulosa, but the drugs still have harmful side effects. Research is being done to treat a hydatid cyst on the liver with herbs.

Disease prevention

Since infection with the disease results from eating food contaminated with eggs, prevention is done by following these steps:

  • Education about personal hygiene
  • Regulate food for pets (eg, stop feeding lamb offal to dogs)
  • Treatment of domestic dogs for intestinal echinococcosis in endemic areas
  • Not to use waste water in agriculture

Finally, the echinococcosis disease that arises from the Echinococcus granulosum parasite leads to the formation of a hydatid cyst in the liver, lung, or other places. These cysts produce symptoms due to pressure on the neighboring structures or perforation of the cysts, which leads to an allergic shock that may kill the patient, so it is a disease that needs treatment. Turkey contains the best centers specialized in this. It is always preferable to try to prevent disease throughout the community.


  1. Centers for Disease Control and Prevention
  2. Medscape
  3. UpToDate

Frequently Asked Questions

Echinococcus granulosa causes cysts in the liver, and it infects humans by eating its eggs, which often go to the liver, resulting in the formation of cysts on the liver.

Hydatid cysts on the liver are not infectious; The only way to transmit the infection is by eating food contaminated with the parasite's eggs.

A hydatid cyst in the uterus or any organ is not surprising, but it is rare.

The liver cyst is sometimes dangerous if it is large and presses on the critical organs nearby, or if it explodes and leads to an allergic shock. In this case, we may not be able to save the patient sometimes, but it usually does not cause a significant problem.

There are several types of liver cysts. Cancerous liver cysts Exists, but a hydatid cyst on the liver does not turn into cancer at all.

The hydatid cyst in the liver may return after the operation if perforation of the cyst occurs during the operation, but this is rare in Turkey because of the experienced hands that perform the procedure. Still, the hydatid cyst is a recurrent disease that may naturally reappear so it is preferable to give albendazole after surgery.

If you are planning for treatment in Turkey
you can talk to us here.

If you are planning for treatment in Turkey
you can talk to us here.