Budd-Chiari syndrome owing to liver hydatid disease: case report and review of the literature

Liver hydatid disease causes significant morbidity but portal hypertension is a rare complication. The mechanism may be pre-hepatic, hepatic, or post-hepatic. Echinococcus granulosus or E. alveolaris may be involved; the latter is associated with infiltration and liver failure. A 13-year-old girl presented with two large unilocular liver hydatids complicated by chronic Budd-Chiari syndrome. Analysis of the ascitic fluid demonstrated a transudate and results of liver function tests were normal. CT scan showed compression at the level of the hepatic veins opening into the vena cava, with multiple collaterals. The patient underwent cystectomy and capittonage which was followed by reversal of the portal hypertension and ascites. This is probably only the second case to be reported in the English-language literature.