[Intraperitoneal perforation of hepatic hydatid cyst]

Abstract

The incidence of the rupture of hydatid cyst of the liver is about 15 to 40% of the cases. In 2 to 7% of the cases the cyst can perforate into the peritoneum. The occurrence of a sclerosing peritonitis secondary to the rupture of the hydatid cyst of the liver was described, to our knowledge, only once. We report the observation of a 43 year-old woman in whom the diagnostis of peritoneal rupture of a liver hydatid cyst was made after 3 months. The patient was treated by albendazole (10 mg/kg/d). Two months after the beginning of this treatment, the patient was operated. A sclerosing peritonitis was discovered. The parasitologic studies of the different specimens were negative. The surgical treatment consisted of a good washing with H2O2 of the fibrous hull of the sclerosing peritonitis and drainage without any dissection. The evolution was satisfactory with albendazole treatment for 14 months. Currently, she is in good health without recurrence and without any abnormalities with a 2 years follow-up. We think that albendazole in the treatment of the hydatid disease is very effective in condition to give a continuous treatment for a long time. The occurrence of a sclerosing peritonitis is fortunately an exceptional situation whose surgical management is very delicate.