Clinical profile, diagnostic challenge and management of alveolar hydatid disease: a prospective study

Background: Although a rare entity, alveolar hydatid disease is associated with significant morbidity. This disease presents a diagnostic challenge because of its low prevalence, unfamiliarity and nonspecific presentation. Aim: To look about the clinical profile, diagnosis and management of these patients.Methods: This prospective study was conducted in the department of surgery at SMHS (Shri Maharaja Harisingh) hospital. All patients with a diagnosis of alveolar hydatid disease of liver during this time period were enrolled in the study.Results: Eight patients in our study were females and 5 patients were males. The age ranged from 21 to 56 years with mean age of 42.07±8.88 years (SD =8.88). The most common presentation in our study was pain abdomen (38%). The most common finding on physical examination was hepatomegaly (30.76%). CT (computerized tomography) scan abdomen gave an impression of alveolar hydatid disease in 5 patients, a suspicion of malignancy in 3 patients and tuberculosis in one patient, and a possibility of liver abscess in one patient. Results of tru cut biopsy were suggestive of alveolar hydatid disease in 4 out of 6 patients. Twelve patients were operated on elective basis (liver radical resection in 8 patients, while “laparotomy and only tumor biopsy” in 4 unresectable patients) and one patient on emergency basis, and all were subjected to histopathological examination. ABZ (albendazole) was given orally at a dosage of 10-15 mg/kg per day.Conclusions: Alveolar hydatid is a rare disease with atypical (unfamiliar) and nonspecific clinical features and atypical radiological features. Also, the disease is associated with significant morbidity, hence a high index of suspicion is needed along with supplementary imaging studies for timely intervention to prevent further complications arising from the disease.