Concurrent hepatic and peritoneal hydatid cysts: A case report

Hydatid disease, or echinococcosis, is a parasitic infection caused by the tapeworm Echinococcus. The simultaneous involvement of hydatid disease in two or more organs is very rare, and the presentation can be nonspecific. A 4-year-old, previously healthy female who presented with a one-month history of progressive, dull-aching pain in the right upper abdomen and suprapubic region, associated with lower abdominal swelling, loss of appetite, and nausea. She came from a rural area with a family history of cattle rearing. On examination, she was comfortable, with normal vital signs and anthropometric measurements. Abdominal examination revealed hepatomegaly and an ill-defined suprapubic mass. Imaging with ultrasound and contrast-enhanced CT revealed a unilocular, thick-walled liver cyst (7.5 × 6.5 cm) involving segments 6 and 7, and a separate large peritoneal cyst (8.5 × 5.5 cm) in the pelvis. Serology for hydatid disease was unavailable, and the diagnosis was made based on imaging. She received albendazole for one week and subsequently underwent elective surgery. The liver cyst was managed via a right subcostal incision with partial pericystectomy and drainage, while the pelvic cyst was excised through a midline suprapubic incision, with the cavity filled using omentum. Both procedures were completed without rupture or significant spillage. Postoperatively, she remained well and was discharged on the sixth day with oral albendazole. Follow-up at 1, 3, and 6 months revealed no complications. Concurrent hydatid cysts should be considered in the differential diagnosis of children who present with multiple cystic lesions within the abdominal cavity.