Multiple Fat- Containing Hepatic Hydatid Cysts: A Case Report in The X- Ray Institute at Medical City Health Directorate in Iraq

Background: Hydatidosis is a zoonotic disease caused by Echinococcus granulosus and Echinococcus multilocularis parasite which is still endemic in many countries all over the world especially in the developing countries. The liver is the primary site to be infested by the parasite with a rate of 60 – 75%. The right lobe of the liver gets infected in about 80% of cases. Hydatid disease of the liver is usually asymptomatic and most cases discovered accidentally on routine clinical or radiological examinations for other illness. Symptoms usually appear in complicated cases either due to rupture, secondary bacterial infection, or due to the large size of the cyst which might cause pain in the right upper quadrant of the abdomen, discomfort, and sometimes swelling. In this case report, we reported the presence of fat globules within the hepatic hydatid cysts which is most probably due to rupture of hepatic hydatid cysts into the biliary tree. Keywords: Hepatic, hydatid cyst, fat globule and CT scan

Postoperative Morbidity Risk Factors After Conservative Surgery of Hydatic Cyst of the Liver: A Retrospective Study of 151 Hydatic Cysts of the Liver

Background: Hepatic hydatid cyst is an endemic parasitosis in Tunisia. Although most of these cysts are benign; their treatment may lead to several complications which can cause an important post-operative morbidity and mortality.The purpose of the present paper is to assess the morbidity and mortality specifics risk factors of hepatic hydatid cysts after conservative surgery.Methods: We conducted a retrospective study of 102 patients over a period of 13 years, from 2006 to 2019. We included all patients operated on for hydatid cyst of the liver, complicated and uncomplicated, in the Department of General Surgery of Mahdia, Tunisia.We excluded patients who received an exclusive medical treatment and those who have other hydatic cyst localizations.Descriptive statistics,bivariate analysis using chi-squared test and Fisher’s exact test for categorical variables;t-test,ANOVA , and Kruskal–Wallis for continuous variables; odds ratio calculations, ordinal and multivariate logistic regression models were appliedResults: The cohort was composed of 102 patients with a total of 151 cysts operated on using conservative surgery, among them there was 75 women (73, 5%) and 27 men (26.5%). The median age was 43, with extremes ranging from 12 to 88 years. The majority of patients (94. 1%) were from rural areas. The cysts were uncomplicated in about half of the cases (48%), elsewhere complications such as compression of neighboring organs (25,5%), opening in the bile ducts (16,7%), infection (9,8%), and rupture in the peritoneum (2%) were found. Conservative surgery was the mainstay of treatment with an overall mortality rate of 1. 9%. The overall morbidity rate was 22%: 14% specific morbidity and 8% non-specific morbidity. External biliary fistula was the most common postoperative complication (9%). The predictive factors of morbidity in univariate analysis were Preoperative hydatid cyst infection (P = 0.01), Compressive cysts (P=0.05), preoperative fever and jaundice, (respectively P=0. 03 and P=0. 02), no one achieved statistical significance in the multivariate modelConclusions:Preoperative hydatid cyst infection, compressive cysts and preoperative fever and jaundice are significant predictor factors of morbidity after conservative surgery for liver hydatid cyst. They must be considered in the treatment and the surgical decision for patients with hydatid cyst.

HYDATIC CYST OF THE LIVER OR HEPATIC MUCINOUS CYSTADENOMA

Mucinous cystadenomas of the liver are rare cystic neoplasms, often mistaken for simple cysts or hydatid cysts of the liver. They are generally benign tumors, often discovered incidentally on imaging or during independent surgeries. Despite their tendency to grow slowly, mucinous cystadenomas of the liver can reach symptomatic dimensions. And given their potential for malignant transformation into mucinous cystadenocarcinomas, a misdiagnosis can have serious secondary consequences. We report the case of a 55-year-old woman with chronic right hypochondrium pain in whom a mucinous cystadenoma of the liver was accidentally discovered during surgery for hepatic hydatid cyst at the general surgery department at the ARRAZI Hospital - UHC Mohammed VI in Marrakech, Morocco.