Intraperitoneal rupture of the hydatid cyst: Four case reports and literature review.

Authors:
Sami Akbulut
Sami Akbulut
Diyarbakir Education and Research Hospital
Turkey
Fatih Ozdemir
Fatih Ozdemir
Istanbul University
Turkey

World J Hepatol 2019 Mar;11(3):318-329

Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey.

Background: Most patients with hydatid cysts are asymptomatic, and they are diagnosed incidentally during radiological evaluations performed for other reasons. However, some patients develop symptoms and complications due to cyst size, location, and the relationship between the cyst and adjacent structures. The most serious complications that can occur are rupture of the cysts into the biliary tract, vascular structures, hollow viscus, and peritoneal cavity. We aimed to describe the management of four cases of intraperitoneal rupture of hydatid cysts.

Case Summaries: Four patients aged between 27 and 44 years (two men and two women) were admitted to our clinic with sudden abdominal pain ( = 4), hypotension ( = 3), and anaphylaxis ( = 2). Three of the perforated cysts were located in the liver, and one was located in the spleen. Two patients developed cyst rupture after minor trauma, and the other two developed spontaneous rupture. Enzyme-linked immunosorbent assay IgG results were positive for two patients and negative for the other two. All patients received albendazole treatment after surgical intervention (range: 2-6 mo). Two patients developed hepatic abscesses requiring drainage; one of these patients also developed hydatid cyst recurrence during postoperative follow-up (range: 25-80 mo).

Conclusion: Intraperitoneal rupture is a life-threatening complication of hydatid cysts. It is important to manage patients with surgical intervention as soon as possible with aggressive medical treatment for anaphylactic reactions.

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Source
http://dx.doi.org/10.4254/wjh.v11.i3.318DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447420PMC
March 2019
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