The American Journal of Case Reports · 5 authors, 4 centres
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This case report describes a 32-year-old man with a giant hydatid cyst involving multiple organs, treated with two-stage surgery including extracorporeal circulation for hemodynamic stability, achieving radical resection and no relapse after 90 days.
Echinococcosis is a zoonosis caused by Echinococcus granulosus, with hepatopulmonary involvement, often asymptomatic, and managed with anthelmintic therapy and surgery. Methods: A 32-year-old man from rural Colombia presented with abdominal pain and fever. Imaging revealed a giant hydatid cyst involving liver, diaphragm, lung, and pericardium, with dimensions up to 152 mm. He underwent two-stage surgery: first, partial resection of cyst involving lung, diaphragm, and rib cage; second, with extracorporeal circulation due to retrohepatic vena cava infiltration, achieving radical resection. Key Results: The first surgery lasted approximately 7 hours with 600 cc blood loss, and the second surgery lasted 6 hours with 350 cc blood loss and 80 minutes of cardiopulmonary bypass. The patient recovered, was discharged with albendazole for 90 days, and showed no relapse after 30, 60, and 90 days. Implications: Extracorporeal circulation assistance may be useful in complex cases with great vessel involvement, but an individualized approach is recommended.
