Background: Infection with Echinococcus granulosus affects the liver commonly, but disseminated
involvement is rare. We describe a 63 year-old man with echinococcal infection producing
both hepatic and cardiac involvement that was managed surgically after failed percutaneous
hepatic treatment.
Methods: This report is a case study of a unique surgical problem. Various treatment modalities
are reviewed.
Results: The patient was a 63 year-old man from Iraq who immigrated to the United States
after becoming infected with Echinococcus granulosus. He had undergone percutaneous management
and albendazole therapy prior to presentation for treatment of hepatic hydatid cysts.
He continued to have abdominal pain and fever and was referred to our institution. Imaging
revealed persistence of the hepatic hydatid cysts, as well as a new finding of an intracardiac
hydatid cyst. The patient underwent successful treatment of his complicated hepatic hydatid
cysts with pericystectomy and repair of a biliary fistula. The cardiac cyst was removed as well.
The patient made an uneventful recovery, and his symptoms resolved.
Conclusion: Although rare, echinococcal infection may be encountered in the United States as
travel increases to and from regions of the world where the disease is endemic. It is important
for surgeons to be familiar with the multiple options for treatment of hydatid disease.
