# Parasitic diseases of the liver

Parasitic diseases of the liver

- The liver is frequently a ff ected by parasitic infections, which, owing to the worldwide prevalence of these organisms, are responsible for considerable morbidity and mortality (see Chapter 6 ). Hydatid disease Human echinococcosis (hydatidosis, hydatid disease) is a para - sitic disease caused by the larval stages of cestodes (tapeworms) - of  the genus Echinococcus . Medical treatment and diagnosis are discussed in Chapter 6 . Surgical intervention is occasionally required when medical management fails, and options range from liver resection or local excision of  the cysts to deroofing with evacuation of  the contents. Contamination of  the perito - neal cavity at the time of  surgery with active hydatid daughters should be avoided by continuing drug therapy with albenda - zole and adding preoperative praziquantel. This should be combined with packing of  the peritoneal cavity with 20% hypertonic saline-soaked packs and instilling 20% hypertonic saline into the cyst before it is opened. A biliary communi - cation should be actively sought and sutur ed. Infection and Summary box 69.13 Infections of the liver /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF 

Pyogenic liver abscesses 1/5000 admissions
Worldwide billions of people have parasitic infections
Parasitic infections cause live abscess and biliary tract
damage
Biliary tract involvement predisposes to cholangiocarcinoma
Parasitic infections mimic pyogenic abscesses
Obstructive jaundice from calci
/f_i
ed
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ukes or involvement of
the biliary tract

greater omentum (an omentoplasty). Calcified cysts may be dead; however, if  doubt exists as to whether a suspected cyst is active, it can be followed on ultrasonography as active cysts gradually enlarge and become more superficial.