Hydatid cyst disease, also known as echinococcosis or dog tapeworm cyst, is a serious parasitic disease transmitted from animals to humans that can be fatal if left untreated. The parasite spreads into the environment through the faeces of carnivores such as wolves, foxes and dogs. The eggs enter the human body through raw, poorly washed fruit and vegetables, dirty hands and contaminated drinking water. They pass into the intestine and from there travel through the blood and lymph to other organs, where they settle. The liver and lungs are most commonly affected.

Prevention

In Türkiye the disease is considered endemic (continuously present in a particular region or community) in South-eastern, Eastern and Central Anatolia, where livestock farming is common. It is seen more often among livestock farmers, agricultural workers, veterinarians, slaughterhouse workers, shepherds and dog owners. Hydatid cyst can be prevented with simple but effective measures:

• Good hand hygiene (especially for people in risk groups)
• Washing fruit and vegetables thoroughly
• Properly burying the organs of dead or slaughtered animals that may contain cysts
• Controlling stray animals
• Keeping drinking and household water clean
• Paying attention to children's hygiene outdoors
• Regular inspection of slaughterhouses
• Not feeding raw meat to dogs
• Deworming pets regularly

Symptoms

In the early stages the disease progresses without symptoms and may be discovered by chance during an unrelated examination. It may also be detected when the growing cyst presses on surrounding tissues, causes symptoms specific to the affected organ, or when the cyst wall ruptures.

Diagnosis

Diagnosis is made with ultrasound, CT or MRI. Imaging determines key features such as the cyst's location, structure, type and number, and treatment is planned accordingly.

Treatment

There are three treatment options: medication, surgery and percutaneous (minimally invasive) treatment. The diagnosing physician plans the most suitable method based on the cyst's structure and the course of the disease. With advances in technology, minimally invasive procedures have replaced open surgery. Recovery is faster, so patients are back on their feet sooner and return to normal life quickly.

Before percutaneous treatment, the patient undergoes some preparation, such as pre-procedure medication and preparation for general anaesthesia. Once our specialist team has completed this preparation, the procedure is performed under general anaesthesia with suitable imaging guidance.

The aim is to drain the cyst fluid with a special needle or catheter and to rinse the cyst cavity with chemical agents such as saline or alcohol to kill the parasite eggs.

In large cysts, a catheter is first secured with one end inside the cyst and the other outside, and the fluid is allowed to drain on its own for a day or two before the cavity is rinsed.

After the fluid has been drained, contrast is injected to check for a fistula (abnormal connection) with the bile ducts or other nearby organs. If a fistula is found, treatment with chemical agents would be dangerous, so the procedure is stopped and the patient is referred for surgery. If there is no fistula and the procedure can be completed as planned, the chance of success is very high.

After the procedure, our specialist team follows patients up at regular intervals.