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.
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.
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.
MRI
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.
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.
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.
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