Giant Hepatic Hydatid Cyst Presenting as Portal Hypertension: A Rare Case Report

Abstract

Hepatic echinococcosis is an endemic parasitic disease in several regions of the world, particularly the Mediterranean basin. A hydatid cyst of the liver is usually a benign condition, but it can lead to rare complications, including portal hypertension due to an intrahepatic obstruction resulting from compression of the portal system. We report the case of a 21-year-old female patient presenting with right upper quadrant pain associated with portal hypertension syndrome, including splenomegaly and hypersplenism. Imaging (ultrasound, CT, MRI) revealed a large hepatic hydatid cyst causing compression of the portal system, confirmed by positive hydatid serology. The patient received medical and surgical treatment combining albendazole and surgical management. The outcome was favorable, with complete resolution of the portal hypertension syndrome at 6 months. This case highlights the importance of considering an infectious etiology, particularly hydatid disease, in any case of portal hypertension due to an intrahepatic obstruction in an endemic area, and serves as a reminder that early treatment to remove the obstruction can lead to complete remission.