Hydatid Cysts of the Liver Rupture into the Peritoneal Cavity: Fifteen Cases and Review of the Literature

Abstract BackgroundHydatid cyst is a parasitic infection caused mainly by E. Granulosus, which is generally considered benign. However, the hepatic Hydatid Cyst rupture in the abdominal cavity is a life-threatening incident that requires urgent and multidisciplinary management (emergency physician, radiologists, anesthetists, and surgeons). This study describes clinical and paraclinical liver hydatid cyst rupture in the peritoneal cavity and details the appropriate treatment.Materials and MethodsFifteen liver hydatid cyst cases ruptured into the abdominal cavity that underwent urgent surgery were collected over eight years. Results There were nine men and six women. Patients' age ranged from 14 to 59 years, with an age average of 38 years. Two patients were admitted with abdominal trauma, and acute abdominal pain was the common consultation's reason. Only one patient had an anaphylactic shock. Both abdominal ultrasound and CT scan showed discontinuous cyst wall and intraperitoneal fluid in 100% of cases. Intraoperatively, the intraperitoneal effusion was clear in thirteen cases and purulent in two. All patients underwent unroofing procedure associated with intra-operative peritoneal lavage and external drainage. The mean hospital stay was 6.11 days, and the mean follow-up was 19 months. No case of recurrence was reported among the patients.ConclusionRupture of a hydatid cyst in the abdominal cavity should be evoked in front of acute abdominal pain, especially in endemic areas, and in the presence of an allergic reaction or anaphylactic shock signs. Combined surgical and medical care starting in the emergency room is the only guarantee of a good outcome.