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

Year 2022, Volume: 12 Issue: 3, 265 - 269, 15.12.2022

Tolga Kalaycı Serkan Tayar

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

References

• 1. Parkoohi PI, Jahani M, Hosseinzadeh F, Taghian S, Rostami F, Mousavi A, et al. Epidemiology and clinical features of hydatid cyst in Northern Iran from 2005 to 2015. Iran J Parasitol 2018;13(2):310–6.
• 2. Acıöz M. Intensive hydatid cyst case in cattle. Middle Black Sea J Health Sci. 2018;4(1):31–3.
• 3. Cantay H, Anuk T. Factors affecting the choice of treatment in hepatic hydatid cyst surgery. J Invest Surg 2022;35(4):731–6.
• 4. Sharma M, Sehgal R, Fomda BA, Malhotra A, Malla N. Molecular characterization of Echinococcus granulosus cysts in north Indian patients: identification of G1, G3, G5 and G6 genotypes. PLoS Negl Trop Dis 2013;7(6):e2262.
• 5. Derici H, Tansug T, Reyhan E, Bozdag AD, Nazli O. Acute intraperitoneal rupture of hydatid cysts. World J Surg 2006;30(10):1879–83.
• 6. Ray S, Das K. Spontaneous intraperitoneal rupture of hepatic hydatid cyst with biliary peritonitis: a case report. Cases J 2009;2(1):1–3.
• 7. Yilmaz M, Akbulut S, Kahraman A, Yilmaz S. Liver hydatid cyst rupture into the peritoneal cavity after abdominal trauma: case report and literature review. Int Surg 2012;97(3):239–44.
• 8. Pourseif MM, Moghaddam G, Saeedi N, Barzegari A, Dehghani J, Omidi Y. Current status and future prospective of vaccine development against Echinococcus granulosus. Biologicals 2018;51:1–11.
• 9. Mor N, Allahverdi TD, Anuk T. The situation of cystic echinococcoses in Kars State Hospital for the last five years. Türkiye Parazitoloji Dergisi 2015;39(2):108.
• 10. Nunnari G, Pinzone MR, Gruttadauria S, et al. Hepatic echinococcosis: clinical and therapeutic aspects. World J Gastroenterol 2012;18(13):1448–58.
• 11. Symeonidis N, Pavlidis T, Baltatzis M, Ballas K, Psarras K, Marakis G, et al. Complicated liver echinococcosis: 30 years of experience from an endemic area. Scan J Surg 2013;102(3):1717.
• 12. Zhang W, Wen H, Li J, Lin R, McManus DP. Immunology and immunodiagnosis of cystic echinococcosis: an update. Clin Dev Immunol 2012;2012:101895.
• 13. Stojkovic M, Rosenberger K, Kauczor H-U, Junghanss T, Hosch W. Diagnosing and staging of cystic echinococcosis: how do CT and MRI perform in comparison to ultrasound? PLoS Negl Trop Dis 2012;6(10):e1880.
• 14. Almulhim AM, John S. Echinococcus Granulosus. 2021 Aug 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. PMID: 30969573.
• 15. Mali S, Jambure R. Anaphyllaxis management: Current concepts. Anesth Essay Res 2012;6(2):115–23.
• 16. Arikanoglu Z, Taskesen F, Aliosmanoğlu İ, Gul M, Cetincakmak MG, Onder A, et al. Spontaneous intraperitoneal rupture of a hepatic hydatid cyst. Int Surg 2012;97(3):245–8.