Hydatid disease of the liver with portal vein invasion and cavernous transformation: A case report and literature review.

Introduction: Hydatid cyst disease is a zoonosis caused by the parasite Echinococcus Granulosus. It may infest any organ of the body, but it most frequently involves the liver and lungs. Portal vein involvement by hydatid cyst disease is extremely rare with only six cases published to our knowledge.

Case Presentation: We present a 47-year-old male with abdominal pain. His laboratory tests were in normal ranges. Upper gastrointestinal endoscopy demonstrated esophageal and gastric fundal varices. The ultrasonography (US) and computed tomography (CT) findings hydatid disease of the liver with portal venous thrombosis and cavernous transformation. It had been treated with albendazole.

Discussion: Hydatid cyst disease is a zoonosis caused by Echinococcus granulosus. It can infest various organs of the body with a particular predilection of the liver and lungs. It still continues to be a health problem in a significant part of the world. The symptoms are frequently non-specific and patients may even be asymptomatic. The portal vein thrombosis is usually accompanied with portal cavernous transformation. Patients with hydatid liver cysts and portal cavernous transformation require treatments for both hydatid cysts and portal hypertension.

Conclusion: invasion of the portal vein and cavernous thrombosis by the echinococcus cysts is a very rare complication. Treatment should consist of both hydatid liver cyst and portal hypertension.