Bilobar hepatic hydatid cyst: a rare encounter with a silent invader

Hydatid disease, caused by Echinococcus species, primarily affects the liver and lungs. It is endemic in many regions, including Nepal, and often remains asymptomatic for years. This report presents a rare case of hepatic hydatid cysts affecting both lobes. A 47-year-old male with a history of alcohol consumption presented with right upper abdominal pain and vomiting. Imaging revealed two thick-walled, multiloculated cystic lesions in both hepatic lobes, classified as Stage CE 2 (WHO-IWGE). The patient was started on albendazole and underwent a successful laparoscopic pericystectomy. While most hepatic hydatid cases involve a single cyst in the right lobe, bilobar involvement is uncommon. Imaging plays a crucial role in diagnosis, and surgical intervention remains the gold standard for treatment. Early recognition and management are vital for preventing complications. This case highlights the need for vigilance in endemic regions to ensure timely diagnosis and optimal outcomes.