Peritoneal Perforation of Liver Hydatid Cysts: Clinical Presentation, Predisposing Factors, and Surgical Outcome

Abstract

The aim of this study was to evaluate the clinical presentation of, predisposing factors in, and early and long-term outcome of patients treated surgically for intraperitoneal ruptured liver hydatid cysts. Medical records of 27 patients with traumatic rupture of hydatid cysts were evaluated retrospectively, as were records of 347 patients with nonperforated hydatid cysts. The ratio of perforation cases to nonperforation cases was 7.8%. Traffic accidents were the most common cause of perforation (n = 16). All patients had abdominal findings, and two patients (7%) had anaphylactic findings. The sensitivities of computed tomography and ultrasonography were 100% and 93%, respectively. Conservative surgical procedures were used for 80.5% of cysts and radical procedures for 19.5%. Associated organ injuries were determined in 10 patients. No significant difference was found between patients with peritoneal perforation and those without perforation in terms of sex (p = 0.403), previous hydatid disease surgery (p = 0.565), localization (p = 0.241), number of cysts (p = 0.537), presence of cystic content infection (p = 0.65), or presence of bile duct communication (p = 0.37). However, there were significant differences in age (p = 0.004), cyst diameter ( > 10 cm) (p = 0.03), and presence of superficially localized cysts (p = 0.011). Three patients developed recurrence. In the group of patients with perforation, the complication and recurrence rates were not statistically different in a comparison of surgical techniques (p = 0.37). No postoperative deaths occurred. The main predisposing factors for cyst perforation are young age and superficial localization. Peritoneal rupture increases the rates of postoperative morbidity and recurrence; in contrast, there was no significant relation between the operative procedure and the morbidity and recurrence rates.

Simultaneous Primary Hydatid Cysts of Liver and Spleen with Spontaneous Intraperitoneal Rupture of Liver Cyst

“…Rupture of intraperitoneal cyst occur less often (3.2% to 16%) and usually occurs after trauma. Significant risk factors for spontaneous rupture are younger age, superficial cyst location, cyst diameter >10cms [4,5]. Intra-peritoneal rupture of a hydatid cyst is considered an urgent clinical event, and dissemination of cyst content poses a 1-2.5% risk of severe, life threatening anaphylactic shock [6].…”

Spontaneous Intraperitoneal Rupture of a Hepatic Hydatid Cyst

“…1,10,11 Hydatid cysts that rupture intraperitoneally can present in various ways ranging from mild abdominal pain to potentially fatal anaphylactic reactions. 4,12,13 The most common symptom on admission is abdominal pain, which is accompanied by vomiting and nausea in most patients. Dissemination of the hydatid fluid and protoscoleces into the peritoneal cavity can evoke allergy-related reactions, like urticaria, fever, hypotension, or anaphylaxis.…”

Liver hydatid cyst which was perforated as a result of trauma in the subcapsular area: a case report

“…Spontan olarak meydana gelebileceği gibi bir travma veya cerrahi girişime bağlı olarak da oluşabilir. Karaciğer kist hidatik perforasyonu için yaş, kist çapının> 10 cm olması ve yüzeysel yerleşim-li olması belirgin risk faktörleri olarak tespit edilmiştir 8 . Hastamızda da kistin çapı 10 cm'den büyük ve yüzeysel yerleşimlidir.…”