Managing multiple hepatic hydatid cysts and a single cardiac hydatid cyst simultaneously through a single surgical entry via the abdomen: A case report.

Introduction And Importance: Hydatid Disease, primarily caused by the larval stage of the parasite Echinococcus granulosus, represents significant health challenges, particularly in endemic regions. Hepatic cysts are more common, while cardiac involvement is rare.

Case Presentation: This report presents the case of a 35-year-old woman with atypical abdominal pain persisting for several months. CT scan of the thorax and abdomen revealed multiple hydatid cysts in the liver and a single cyst in the apex of the heart. The intramyocardial cyst was asymptomatic. Albendazole was administered pre- and postoperatively. The surgical approach commenced with the hepatic cysts, accessing the area via a bilateral Kocher subcostal incision in the epigastric region. The second step involved an incision of the central diaphragm, providing clear visualization of the cardiac apex. The operation was successful and the patient was discharged without any complications.

Clinical Discussion: There are many surgical techniques described in the literature. Recently, single-stage operations have been recommended to manage multiorgan hydatid cysts; however, having two surgical incisions in one operation can still be dangerous to the patient's health.

Conclusion: To our knowledge, this is the first case that describes a surgical technique that begins in the abdominal cavity and then progresses to the thoracic cavity through the diaphragm to manage both hepatic and cardiac hydatid cysts.