Hepatic Hydatid Cyst Diseases during Pregnancy: Diagnosis, Management and Best Practice

Abstract

Ibrahim Falih Noori, Azza Sajid Jabbar

Hydatid cystic disease is parasitic infestation caused by a tape worm Echinococcus granulosus. It is a common health problem especially in endemic areas such as Mediterranean and Middle East countries including Iraq. Liver and lungs are most common organ affected by hydatid cyst although all organ and tissues are liable to harbor such cyst. Hydatid cyst during pregnancy is rare with estimated incidence of 1in 20000 -30000. Most cases of hydatid cysts during pregnancy are asymptomatic and discovered accidentally during prenatal care, however decreased cell- mediated immunity and steroid produced by placenta may accelerate parasitic growth and as a result hydatid cyst enlarge in size giving rise to symptoms and complications. Although the ultimate diagnosis of hydatid cyst disease can easily be made by imaging and serology, its treatment is still a matter of debate since there is no general consensus and clear- cut guidelines are available for the ideal management of hydatid disease during pregnancy and each case should be individualized. Treatment options for hepatic hydatid cyst during pregnancy include expectant observation, medical treatment, percutaneous aspiration and surgery. In this article we present our clinical experience about management of 5 pregnant patient with liver hydatid cysts.