Although echinococcal disease of the liver is common in some parts of the world, it is rarely seen in the United States. Even from endemic areas, few reports deal with its treatment during pregnancy. A 25 year old 18 week pregnant Italian woman presented with pruritis and right upper quadrant pain. Ultrasound revealed a cystic lesion in the left lobe of the liver. The cyst was treated by operative insertion of hypertonic saline and capsulorrhaphy. The patient and her fetus had no postoperative complications. We believe that the pregnant patient with symptomatic hepatic echinococcal disease should be treated operatively and that insertion of hypertonic saline and capsulorrhaphy is the safest and most effective technique for both the mother and fetus.
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