Abstract:
A 33-year-old male with abdominal distention after meals was admitted to the hospital. He had a history of surgery for
hydatid liver cyst. The cyst was located at the liver hilum and there were portal venous thrombosis and cavernous
transformation. It had been treated with partial cystectomy, omentoplasty and albendazole. Two years later at the
admission to our center, his laboratory tests were in normal ranges. Abdominal imaging methods revealed splenomegaly,
portal vein thrombosis, cavernous transformation and the previously operated hydatid liver cyst. Upper gastrointestinal
endoscopy demonstrated esophageal and gastric fundal varices. Due to his young age and low risk for surgery, the
patient was planned for surgical treatment of both pathologies at the same time. At laparotomy, hydatid liver cyst was
obliterated with omentum and there was no sign of active viable hydatid disease. A meso-caval shunt with an 8 mm indiameter
graft was created. In the postoperative period, his symptoms and endoscopic varices were regressed. There
were four similar cases reported in the literature. This one was the youngest and the only one treated by a surgical shunt.
Hydatid liver cysts that located around the hilum can lead to portal vein thrombosis and cavernous thrombosis.
Treatment should consist of both hydatid liver cyst and portal hypertension. To the best of our knowledge, this was the
first case of surgically treated portal vein thrombosis that was originated from a hydatid liver cyst.
