Hydatid disease (HD), or echinococcosis, is a zoonotic parasitic infection caused by the larval stage of the Echinococcus tapeworm. It is endemic in several regions globally, particularly in rural areas of southern South America, Central Asia, China, parts of Africa, the Mediterranean basin, and the Middle East. The liver is the most affected organ, followed by the lungs. However, the disease can involve almost any organ, including the brain, bones, and, in rare instances, the pelvic region, as highlighted in this case report. HD often progresses silently, remaining asymptomatic during the initial stages and sometimes even for years. The clinical presentation is usually non-specific, with common symptoms including abdominal pain, hepatomegaly, and, in severe cases, anaphylaxis following cyst rupture. Extrahepatic, intra-abdominal hydatid cysts are particularly rare, occurring in only 6–11% of cases, making this presentation an unusual and noteworthy clinical finding. In this case, a 32-year-old female involved in animal husbandry and farming presented with a progressively enlarging lower abdominal lump, accompanied by intermittent abdominal pain and constipation. Hydatid cysts involving multiple abdominal structures, including the liver, spleen, omentum, broad ligament of the uterus, and pelvis, are uncommon occurrence. Such complex cases pose considerable challenges in diagnosis and management, highlighting the importance of a careful and collaborative multidisciplinary approach. This case report highlights the complexities associated with diagnosing and managing abdominal hydatidosis, particularly in its atypical presentations. Accurate diagnosis relies on a comprehensive approach, integrating clinical assessment, serological investigations, and advanced imaging techniques.
Bairwa et al. (Fri,) studied this question.