Anaphylaxis during puncture of a hepatic hydatid cyst

Abstract

Although hydatid cyst infects many organs, it most commonly involves liver, lungs, and central nervous system. The goal of hydatid cyst treatment is to completely eliminate the parasite and to prevent recurrences with minimal mortality and morbidity. The procedure of puncture, aspiration, injection of a scolicidal, and reaspiration (PAIR) of a cyst has been introduced as an alternative to surgical method since it is less invasive and less morbid and is associated with a shorter hospital stay and a lower cost. Herein, we report an 11-year-old girl who developed anaphylaxis during the puncture of a hepatic hydatid cyst. The patient who developed anaphylaxis during the PAIR procedure was administered intravenous adrenaline, methyl prednisolone, and antihistaminic medication. She was intubated and provided assisted ventilation using a mechanic ventilator. The child was extubated 4 h after her admission to the pediatric intensive care unit. During follow-up, the contents of her hepatic hydatid cysts were aspirated through a catheter, followed by their irrigation with 20% sodium chloride and re-aspiration. Then, 97% ethyl alcohol was injected into the cyst cavity to make it collapse. The goal of this report was to draw attention to the rare occurrence of anaphylaxis during the PAIR procedure and to stress that clini-cians should be vigilant for this complication.

Keywords: Anaphylaxis; PAIR procedure; hydatid cysts.

FIGURE 1

The cyst cavity bile tracts.