Back Ground : Hydatid disease is a Zoonotic infection , that has a world wide distribution ,It is endemic in many cattle raising regions of the Mediterranean , Middle east ( Including Iraq) Far east , South America, Australia and certain areas of North America. Purpose: Comprehensive review of 150 Iraqi patients with hepatic hydatid cysts and to compare the results with that of Iraq and surrounding countries Similar studies . Methods: This study was based on data collected from 150 patients , admitted to gastroenterology and hepatology teaching hospital in Baghdad with one or more hepatic hydatid cyst. Each patient was evaluated by history, clinical examination & investigated by complete blood picture , liver function test , abdominal ultrasound & chest X Ray. CT scan of the abdomen MRI, MRCP, Esophagogastrodudenoscopy, ERCP, were done for some of the patients .GHARBI Classification was used to categories Hydatid cysts into 5 types. Endocystectomy was the way to deal with cyst in 56.6% of the cases . CBD was explored in 10%of the cases. While ERCP was done in 44% of the cases to deal with CBD obstruction. In 52% of the patients , operation was done once for the patient. The residual cavity was dealt with in most of the patients by either leaving a drain beside the cyst ( in 32% of the patients) , Or by external drainage ( In 28.6% of the patients ) . Results : There were 74 Male and 76 female. The mean age of patient was 38.9 year ( The age range was from 3-85 year) . & patients ( 4.7%) were Asymptomatic & were accidently discovered to have abdominal hepatic hydatid disease , While 143( 95.3%) were symptomatic. Upper abdominal pain was the most common presenting symptom, in 74% of the patients . Most of the cysts were in segment 7( 23.5%) and in segment 8 ( 21.5%). Most of the patients got just one cyst in their liver( 58%). Most of the cysts were type 3( 22.3%)and type 4 ( 22.3%)according to Gharbi classification. In 27.4% of the patients the cysts were ruptured to the biliary tree at the time of diagnosis. In 52.5% of the patients the liver was involved alone by the hydatid cyst . The patients with the cysts were treated either by medical treatment alone, Interventional therapy , surgery alone , or with more than one of the mentioned treatment modalities. Recurrence was recorded in 20% of the case. The cysts were infected in 72% of the cases. 4 patients died( 2.6%). In all of them the causes of death were related to late presentation and cyst complications. Conclusions Most of our patients were young and mostly presented with upper abdominal pain. Liver is the most organ to be involved in the peritoneal cavity. Segment 7, and 8 were the most commonly involved liver segments. Cyst were mostly of type 3, and 4 according to Ghrabi classification. Cysts were ruptured into the biliary tree in 27.4% of the cases. Most of the cases were diagnosed very late , and are usually presented with complications , especially rupture into the biliary tree, or infection , which leads to high morbidity and mortality.
Back Ground : Hydatid disease is a Zoonotic infection , that has a world wide distribution ,It is endemic in many cattle raising regions of the Mediterranean , Middle east ( Including Iraq) Far east , South America, Australia and certain areas of North America. Purpose: Comprehensive review of 150 Iraqi patients with hepatic hydatid cysts and to compare the results with that of Iraq and surrounding countries Similar studies . Methods: This study was based on data collected from 150 patients , admitted to gastroenterology and hepatology teaching hospital in Baghdad with one or more hepatic hydatid cyst. Each patient was evaluated by history, clinical examination & investigated by complete blood picture , liver function test , abdominal ultrasound & chest X Ray. CT scan of the abdomen MRI, MRCP, Esophagogastrodudenoscopy, ERCP, were done for some of the patients .GHARBI Classification was used to categories Hydatid cysts into 5 types. Endocystectomy was the way to deal with cyst in 56.6% of the cases . CBD was explored in 10%of the cases. While ERCP was done in 44% of the cases to deal with CBD obstruction. In 52% of the patients , operation was done once for the patient. The residual cavity was dealt with in most of the patients by either leaving a drain beside the cyst ( in 32% of the patients) , Or by external drainage ( In 28.6% of the patients ) . Results : There were 74 Male and 76 female. The mean age of patient was 38.9 year ( The age range was from 3-85 year) . & patients ( 4.7%) were Asymptomatic & were accidently discovered to have abdominal hepatic hydatid disease , While 143( 95.3%) were symptomatic. Upper abdominal pain was the most common presenting symptom, in 74% of the patients . Most of the cysts were in segment 7( 23.5%) and in segment 8 ( 21.5%). Most of the patients got just one cyst in their liver( 58%). Most of the cysts were type 3( 22.3%)and type 4 ( 22.3%)according to Gharbi classification. In 27.4% of the patients the cysts were ruptured to the biliary tree at the time of diagnosis. In 52.5% of the patients the liver was involved alone by the hydatid cyst . The patients with the cysts were treated either by medical treatment alone, Interventional therapy , surgery alone , or with more than one of the mentioned treatment modalities. Recurrence was recorded in 20% of the case. The cysts were infected in 72% of the cases. 4 patients died( 2.6%). In all of them the causes of death were related to late presentation and cyst complications. Conclusions Most of our patients were young and mostly presented with upper abdominal pain. Liver is the most organ to be involved in the peritoneal cavity. Segment 7, and 8 were the most commonly involved liver segments. Cyst were mostly of type 3, and 4 according to Ghrabi classification. Cysts were ruptured into the biliary tree in 27.4% of the cases. Most of the cases were diagnosed very late , and are usually presented with complications , especially rupture into the biliary tree, or infection , which leads to high morbidity and mortality.