Intraperitoneal rupture of the hydatid cyst disease: Single-center experience and literature review

Abstract

BACKGROUND:The primary aim of this study was to present our experience in the intraperitoneal rupture of the hydatid cyst in the guidance of literature data.METHODS: Demographical, clinical, radiological and postoperative follow-up data of 29 patients who underwent surgical treatment in our institution with the diagnosis of intraperitoneal rupture of the hydatid cyst from January 2003 to July 2020 were analysed retrospectively in this study.RESULTS: Among the 29 patients with an age range of from 16 to 79 years (median= 39, IQR=25.5), 16 were male (55.2%), and 13 were female (44.8%). Intraperitoneal rupture of the hydatid cyst was spontaneous in 21 (72.4%), traumatic in seven (24.13%) (two of them were iatrogenic) and was due to shotgun in one patient. Vast majority of the patients were admitted to the emergency department in the first 24 hours after the onset of sign and symptoms. WBC varied from 8.600 to 30.900/mm 3 (median=12.100, IQR=5.7). Ruptured cysts were localised in liver (n=25, 86.2%), in spleen (n=2, 6.89%) or in pelvis (n=2, 6.89%) and diameter varied from 40 to 200 mm (median=90, IQR=50). Among the cysts ruptured in liver, 19 (76%) of them were localised in the right lobe. Among the ruptured cysts of the liver, 20 (80%) of them underwent conservative surgery (e.g., partial pericystectomy), the remaining five patients (20%) underwent a radical surgical treatment (e.g., pericystectomy). A biliary orifice was diagnosed during surgical exploration in either cyst cavity or cut surface of the liver in 12 (48%) of the patients. Patients with a dilated common bile duct or a visible biliary duct orifice in cystic cavity underwent common bile duct exploration and T-tube drainage procedure (n=6, 24%). One patient died on postoperative day one, due to cardiopulmonary complications secondary to cyst rupture. All along the postopeartive follow-up of median 1416 days, seven (24.1%) patients were diagnosed for diseased recurrence. CONCLUSION:Intraperitoneal rupture of the hydatid cyst is a life-threatening complication of hydatid cyst disease, for which diagnosis without delay and timing of surgical treatment is essential. Anaphylactic shock require rapidly initiation of medical treatment against allergic reactions. Despite scolocidal agents, vesicular spread into peritoneal cavity accounts for the major risk factor for disease recurrence. Hence, abdominal cavity should be explored cautiously.

Intra‐biliary hydatid cyst rupture: A rare case report with superinfection

“…However, some patients may experience symptoms, such as nausea, vomiting, stomach pain, and jaundice. Hydatid cysts can produce symptoms when they reach 10 cm in diameter, or when complications arise, largely depending on their size and location 3,4 . Complications from hydatid disease can include secondary bacterial infection, mass effects, and ruptures.…”

“…Hydatid cysts can produce symptoms when they reach 10 cm in diameter, or when complications arise, largely depending on their size and location. 3 , 4 Complications from hydatid disease can include secondary bacterial infection, mass effects, and ruptures. In addition, hydatid cyst ruptures fall into one of three categories: communicating ruptured cysts, containing ruptured cysts, or directly ruptured cysts.…”