Background. Hydatid cyst disease is a zoonosis caused by Echinococcus genera. The disease is endemic to certain rural areas in the world. Operative treatment is the main component in curing hydatid cysts of the liver. Objective. Describing the unique characteristics of the hydatid cyst patients in Israel, a nonendemic country. Methods. Data was collected form 29 patients treated operatively in Rabin Medical Center from 1994 to 2007. Results. The study included 18 females and 11 males with an average age of 54.9 years. Fifty-two% of the patients immigrated as children from Arab countries to Israel, 21% were Arab-Israelis leaving in the north and center of Israel, and 24% immigrated from the former Communist Bloc. Pericystectomy was performed in 20/29, and cyst unroofing was performed in 9/29. Hydatid cysts average size was 10.7？cm, and the cysts were located in the right or left or involved both lobes in 62%, 28%, and 10% of the lesions, respectively. Postoperative mortality occurred in one case, and severe morbidity occurred in 4 patients. Conclusions. Hydatid cyst disease in Israel is uncommon and is mostly seen in distinct 3 demographic groups. Despite the relatively low patient volume, good results in terms of morbidity, mortality, and recurrence were achieved. 1. Introduction Hydatid cyst disease is a zoonosis caused mainly by the cestode genus Echinococcus granulosus (and to much lesser extent, other 3 Echinococcus genera). The incidence of this disease is strongly correlated with certain geographic areas in the world. It is endemic to many rural areas where humans are in close contact with the different hosts in the complex life cycle of the parasite. Livestock (e.g., sheep and cattle) are the intermediate host, and small carnivores (e.g., dogs) are the definitive hosts. In humans, like in herbivores, the ingested eggs hatch, and then a hydatid cyst filled with larvae is formed. The larvae cannot develop into its adult form unless it is digested by a carnivore. In 50%–70% of hydatid disease cases, the liver is involved [1]. Hydatid cysts are asymptomatic for long periods of time in many cases [2] and are diagnosed as an incidental finding or when they become symptomatic. The cysts tend to grow and cause local mass effect, or in other cases they can get infected. Cyst growth can also cause rupture and peritoneal dissemination or anaphylaxis when the cyst content is exposed to the immune system. A connective tissue capsule, a pericyst, is formed around the parasite to seclude it from the host. The pericyst plays an important role as a plane for
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