Hydatid Recurrence Medically Treated by Albendazole

Hydatidosis or Cystic Echinococcosis (CE) is a highly endemic parasitosis in Tunisia. The combination of surgery with an adjuvant anti-hydatid medical treatment was shown to reduce the risk of relapses, recurrences and post-operative complications.

We report the case of a liver hydatid cyst recurrence in a woman hospitalized for acute cholangitis of hydatid origin. The patient had a resection of the protruding dome and a bipolar drainage of the main bile duct and cystic cavity with a postoperative biliary fistula and a collection of the residual cavity that required endoscopic sphincterotomy. The patient was then followed up every 6 months. Three years after the intervention, CT scan showed a hydatid recurrence of two new liver cysts. Surgery was expected to be difficult and risky. Medical treatment with albendazole was decided before surgery.

The CT scan performed after 9 months showed important regression of two hydatic cysts. Medical treatment has been extended. Two years later, CT scan was in favor of an involuted aspect of both cysts.

The treatment of CE is primarily surgical; medical treatment alone or associated with surgery can be a good alternative, especially in case of hydatid recurrence and when surgery is risky, mainly in stage I hydatic cyst.