Hepatic hydatid disease in Iran, with review of the literature.

We retrospectively reviewed 126 surgically proven cases of hydatid cyst of the liver selected from medical records of patients diagnosed clinically over the eight-year period 1972 to 1980. Sixty percent of the patients were in the third and fourth decades of life. The most common initial complaint was either right upper abdominal pain or a sensation of fullness, generally for more than two months. One or more cysts were more apt to be in the right lobe, and were subject to infection, rupture, or fistula formation. In 6% of patients, other intraabdominal cysts were found during surgery. In a few patients, the plain abdominal radiographs revealed curvilinear calcification. Upper gastrointestinal barium studies showed extrinsic pressure on the stomach or duodenum. Chest radiographs occasionally showed elevated right hemidiaphragm, right lower lobe infiltrate/atelectasis, right pleural effusion, and a pulmonary hydatid cyst. Liver-spleen scintigraphy often revealed a space-occupying lesion, but there were discrepancies either in number or location of cysts when compared with the surgical findings. All angiographic results were abnormal. Patients with infected cysts differed from the rest by a more common history of fever, and a greater incidence of right pleural effusion on chest x-ray. Literature on pathophysiology, radiologic findings (including CT scan and ultrasonography), and surgical and medical therapy of hydatid disease of the liver is reviewed.