A Serious Complication of Liver Hydatid Cyst: Intra-abdominal Rupture

Abstract

Intra-abdominal rupture is a severe and rare complication of a hydatid cyst. This case report is aimed to present the diagnosis and treatment algorithm for spontaneous intra-abdominal rupture of liver hydatid cyst. A 46-year-old lady was followed up in the gastroenterology service with a cholangitis diagnosis. Endoscopic retrograde cholangiopancreatography (ERCP) was applied to the patient. The patient’s abdominal pain and vital signs worsened on the first day after ERCP. After the patient was hemodynamically stabilized, intravenous contrast-enhanced computed tomography (CT) was performed. On CT, there was a 130 mm diameter air-containing hydatid cyst in the liver dome accompanied by intraperitoneal free air. Liver hydatid cyst perforation was considered in the patient, and the patient was taken for an emergency laparotomy. Cystotomy and unroofing were performed with cholecystectomy. Control thorax CT was performed on the patient due to low saturation (90% under nasal oxygen support) on the sixth day of followup. Due to pleural effusion in the right hemithorax on the CT scan, thoracentesis was performed on the patient, and 500 cc of seropurulent fluid was aspirated. On the 14th postoperative day, the patient was discharged without any problem and was prescribed 10 mg/kg/day of albendazole. No pathology was detected on the control CT in the first-month follow-up.

Keywords

• albendazole
• anaphylactic reaction
• echinococcosis
• spontaneous rupture

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