Pakistan Journal of Medical and Health Sciences Vol. 5, Issue 4, OCT – DEC 2011 Website: www.pjmhsonline.com Citation: Mustafa M I T, Abbas M, Khan A A, Mustafa R I T (2011). Hydatid Cyst of Liver: A Case Report. PJMHS, 5(4): 803-805. Hydatid Cyst of Liver: A Case Report MUSTAFA ISSA TAYEH MUSTAFA 1 , MAZHAR ABBAS 2 , AZHAR ABBAS KHAN 3 , RAMI ISSA TAYEH MUSTAFA 1. Department of Surgery, Fatima Jinnah Medical College/Sir Ganga Ram Hospital, Lahore 2. Department of Surgery, District Head Quarter Hospital, Bhakkar, Punjab 3. Department of Entomology, University of Sargodha, Correspondence to Dr. Mustafa Issa Tayeh Mustafa, Surgical Specialist Email: drmustafaissa@yahoo.co.uk & Dr. Mazhar Abbas, Surgical Specialist Email: drmazhar1@yahoo.com ABSTRACT Hydatid disease is a parasitic infection by a tape worm of the Genus Echinococcus. It effects human as well as other mammals like; sheep, dogs, rodents and horses. Hydatid cyst is one of the known cause of Liver mass. Investigations and appropriate management provides improved quality of life and substially decrease mortality ratio. We are presenting here a case of Hydatid cyst left lobe of Liver, in which left lobe was converted into a cyst. So complete left lobectomy was done at District Head Quarter Hospital, Bhakkar. A twenty-five year old female, residing in District Bhakkar, presented with intermittent abdominal pain for 2 years. Abdominal sonography showed a multiloculated cystic mass in the left lobe of liver with some punctuate calcifications at the peripheral wall and thickened septa. Under the impression of hepatic hydatid cyst, the patient received left lobectomy. Histological study of the lesion showed a cyst with many daughter cysts lying free in the cyst fluid. Hydatid cyst may be asymptomatic or may lead to lethal complications. Surgery is considered the optimal treatment that has the potential to remove the cyst and leads to complete cure. It is important to make a preoperative diagnosis based on the typical image findings, so that surgeons may take particular precaution not to rupture the lesion as peritoneal spillage may lead to disseminated implantation. Key words: Hydatid cyst, liver CASE REPORT A twenty-five year old female presented with intermitted upper abdominal pain for two years. She is a villager and there was history of weight loss and off/on history of fever. There was no previous hospitalization and surgical interventions. No significant family history could be found. There was history of keeping sheep and Goats at home. On clinical examination patient was a fibrile vital were stable, systematic review was normal. Abdominal Examination: 4X4 cm mass firm in consistency in Epigastric area moves with respiration slight tenderness in epigastric area. There were no visible pulsation or penstaltic movements on it. USG abdomen CT. Abdomen were both in favour of Hydatid cyst involving left lobe of Liver completely. According to clinical history and image finding Hydatid cyst was suspected. The patient was admitted in surgery department for further treatment. Physical examination was generally normal. The data of CBC and serum biochemistry was unremarkable. The serological test including the hydatid immunoelectrophoresis, enzyme-linked immunosorbent assay (ELISA), latex agglutination and indirect haemagglutination (IHA) test were not performed during admission. Her stool was soft and brown and no parasites were found. Abdominal sonography showed a complex cystic lision with solid component in left lobe of liver. Some mobile echogenic foci within the cyst were noticed during posture change of the patient. Patient prepared for Exploratory Laparotomy, fitness for General Anesthesia confirmed. Upper mid line with extension into left hypochondrium Incision made. After breaking omental adhesion whole abdomen covered with Hypertonic sterile soaked sheets (Fig.1).