Ashwani Kumar Dalal1, Usha Rani Dalal2, Amish J. Wani3

The classical finding in hydatid disease caused by Echinococcus granulosus with liver or lung involvement is well known. However, diagnosing hydatid disease at unusual locations maybe challenging even in endemic areas causing diagnostic confusion as primary extrahepatic extrapulmonary hydatid cysts are rare and only a few sporadic cases have been reported. We present a case where a painless progressive cystic swelling was present in left inguinal region with positive cough impulse and irreducibility mimicking an inguinal hernia. CECT was done, which confirmed it to be multiple hydatid cysts. The patient underwent excision of the cysts with mesh repair and left inguinal orchiectomy as the cord structures couldn’t be separated from the cyst wall. Patient was discharged in satisfactory condition on oral antibiotics and albendazole. No recurrence noted on 6 months of follow up. So, a high suspicion for hydatid cyst should be kept in mind especially in endemic areas for any intra-abdominal swelling. The surgeon must keep in mind that this parasitosis can occur even in uncommon locations and therefore it should be regarded as a potentially systemic disease. In these cases, the diagnosis is challenging and can be achieved only through a complete interdisciplinary evaluation clinical, laboratory and radiological data.