Hydatid disease of the liver (Part two)

Diagnosis

1. Serological tests.

The hydatid fluid contains specific antigens, the release of which leads to the sensitization of patients with the production of antibodies. The indirect hemagglutination test, ELISA, and complement fixation test are positive in 85% of patients.

2. Ultrasound

The ultrasonographic classification is

1. Ultrasound with a single cyst
2. Ultrasound with multiple cysts
3. Ultrasound with daughter cysts
4. Ultrasound as a soccer ball
5. Ultrasound serpentine form

3. Magnetic resonance imaging can show daughter cysts, detachment of the membrane.

4. ERCP can reveal cysts in the bile ducts.

The diagnosis of echinococcosis is entirely imaging-based, confirmed by serological tests

Based on the ultrasonographically identified forms, we also suggest the presence of alveolar echinococcosis in Albania.

Alveolar echinococcosis primarily affects children and has a preference for the right lobe of the liver. The affected liver tissue undergoes necrosis with a pulpy consistency. The tissue often has a yellow color due to perifocal xanthomatous inflammation. When calcifications and necrosis are absent, it is very difficult for this lesion to be distinguished from malignant tumors. Serological tests are decisive for diagnosis. E. alveolaris causes infiltrative lesions with unclear contours and extends to the abdominal wall, diaphragm, or at the level of the portal vein.