Ruptured Hydatid Cysts into the Peritoneum: A Case Series

Abstract

Introduction: The rupture of a hydatid cyst into the abdominal cavity is a rare and serious complication.

Methods: In this retrospective study, we evaluated ten patients who were surgically treated for ruptured hydatid cysts into the peritoneum at a university hospital in an endemic area between 2003 and 2008.

Results: There were three female and seven male patients, with a mean age of 34.2 years (range 20-79). Ruptured cysts were located in the liver (7), pelvis (2), and spleen (1). Eight patients had other nonperforated hydatid cysts. Perforations were spontaneous in seven patients and traumatic in three. Patients' diagnoses were done with abdominal ultrasound (3), computed tomography (6), and laparotomy (1). The surgical treatment of perforated cysts were radical (pericystectomy) in one patient and conservative (partial pericystectomy) in the other nine patients. There was postoperative morbidity (surgical site infection) in one patient and one postoperative recurrence of disease in another patient. Mortality was seen in one patient 2 months after operation due to pulmonary hydatid cyst and infection.

Conclusion: The rupture of hydatid cysts into the peritoneal cavity should be included in the differential diagnosis of acute abdominal pain in endemic areas. Perforation in a young patient may be the first presentation of hydatid cyst. Multiple hydatid cysts may be a predisposing factor for perforation. Location of the cyst on segment VI of the liver may be a predisposing factor as well. Emergency surgery is the main treatment for intraperitoneal rupture of hydatid cysts and medical treatment should be given postoperatively.

Keywords: Acute abdomen; Hydatid cyst; Peritoneum; Rupture.