Giant Hydatid Cyst of the Liver Presenting With Severe Chest Pain and Deformity

Cystic echinococcosis (CE) is a parasitic disease caused by a larval stage (metacestode) of Echinococcus granulosus (E. granulosus), which is still endemic in many countries worldwide, despite the efforts of the World Health Organization (WHO) to reduce the disease burden in those countries. The hydatid cysts of the liver tend to grow gradually over a long period of time and may cause a variety of symptoms, either related to compression of adjacent organs or rupture. Here we report an unusual case of a giant hydatid cyst of the liver presenting to the emergency room (ER) of our hospital with chest deformity and severe chest pain, heralding impending rupture. Considering the very large size of the cyst (26×20 cm) and severe pain, we deemed expeditious surgery to be the best option. Upon surgery, the cyst contents were evacuated, biliary connections were ligated, and measures were taken to prevent the dissemination of the disease into the abdominal cavity. Closed drainage was used since the patient had almost no omentum. The patient received albendazole pre- and postoperatively. The patient was discharged in good condition after one week in the hospital.