HOW TO MANAGE ASYMPTOMATIC LIVER HYDATIDS

Cystic echinococcal disease disappeared many decades ago from industrial countries. Only rarely now, and primarily because of increased international travel, liver hydatids surface as clinical curiosities at medical conferences in western countries. The situation is usually that of a liver hydatid having ruptured into the biliary system causing bile duct obstruction. Invariably the consensus among discussants is that the patient should have been operated upon much earlier to avoid the cyst becoming complicated. Such a verdict, however, is inappropriate and inapplicable in endemic areas of developing countries where echinococcal disease is still rampant.1 In these regions so many cases of asymptomatic cases of liver hydatids are detected in the course of ultrasound investigation for other conditions, that it would impossible to handle all of them surgically.