Abstract
We report a case of hepatic alveolar echinococcosis (HAE) with complete obstruction of the inferior vena cava (IVC). A 43-year-old man developed chest pain. Abdominal CT revealed a 13-cm low-density mass with calcification in the left and caudal lobes of the liver, complete posthepatic IVC obstruction and right adrenal infiltration. We diagnosed HAE based on serological testing. Preoperative abdominal CT also showed the development of the ascending lumbar veins, azygos vein and hemiazygos vein as collateral circulation for the IVC. He underwent left hepatic trisegmentectomy with resection of the caudal lobe, right adrenal gland and completely obstructed suprarenal IVC. We resected the suprahepatic IVC at a position where the right hepatic vein was preserved. The IVC was not reconstructed, because the infrarenal IVC remained uncongested due to the large collateral veins. The patient had an uneventful recovery and is undergoing adjuvant albendazole therapy. We should perform reduction surgery with adjuvant albendazole treatment for patients with HAE that cannot be completely resected. Furthermore, in cases of hepatectomy with IVC complete blockage, reconstruction of the IVC is unnecessary when the developed collateral veins could be checked preoperatively.
