Chapter 20

Parasitic Hepatic Cysts and Pyogenic Hepatic Abscess

Hadj Omar El Malki, Amine Souadka, Vinicius Grando Gava and Silvio Marcio Pegoraro Balzan

Abstract

• The most common parasitic hepatic disease that can need surgical treatment is the hydatid cyst, caused by Echinococcus granulosus. Other echinococcosis (alveolar and polycystic) are less frequent. </p><p> • Hydatid cysts may be multiple and can measure up to 20-50 cm in diameter. Most of them develop in the right lobe of the liver. Commonly, symptoms result from mass effect or cystic complications, such as rupture (into biliary tract, peritoneal cavity, hollow viscera, and lungs) or infection. Diagnosis is suggested especially by radiological findings. </p><p> • Surgical treatment can be conservative (comprising sterilization of the cyst and treatment of the residual cavity) or radical (including pericystectomy and anatomical liver resections). </p><p> • Pyogenic liver abscess represents a life-threatening bacterial infection of the liver. Surgical treatment is indicated in case of failure of conservative therapy (antibiotics combined or not with percutaneous drainage), which occurs mainly in multiloculated abscesses and those with biliary communications.

Total Pages: 343-361 (19)

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