Spontaneous intraperitoneal rupture of hepatic hydatid cyst: a rare cause of ascites

BMC Surgery

Chakib Kraiem¹  Dejla Bakir¹  Rached Letaief²  Habib Amara¹  Abdelmajid Khnissi²  Mosaab Ghannouchi²  Houneida Zaghouani¹  Sana Yahyaoui¹  Manel Limeme¹ 

[1] Department of Radiology, Farhat Hached hospital, 4000 Sousse, Tunisia;Department of General Surgery, Farhat Hached hospital, 4000 Sousse, Tunisia

关键词: Liver;    Spontaneous rupture;    Hydatid disease;   

Others  :  1091060
DOI  :  10.1186/1471-2482-14-99

 received in 2014-01-10, accepted in 2014-07-15,  发布年份 2014

【 摘 要 】

Background

Hydatid disease is endemic in certain areas of the world and it is located mostly in the liver. Intraperitoneal rupture is rare. Rupture may result from trauma or may occur spontaneously from increased pressure of the cystic fluid. Ruptured hydatid cyst is a rare cause of ascites, but should be considered in the differential diagnosis, especially in endemic areas. The diagnosis of ruptured hydatid cyst should be prompt because it requires emergency intervention.

Case presentation

The present case refers to a 62 year old Tunisian male admitted in our institution for diffuse abdominal distension. Physical examination was unremarkable except for the presence of ascites. Abdominal ultrasonography showed a large amount of fluid into the peritoneal cavity associated with many intraperitoneal cysts with a scalloping on the liver. It showed also a heterogeneous cystic lesion of the segment II of the liver. Abdominal computed tomography (CT) revealed in addition a fat infiltration and a thickening of the peritoneum. Thus intraperitoneal hydatid cyst rupture was suspected and emergency laparotomy was performed. A yellow serous fluid , containing many daughter vesicles disseminated through the peritoneal cavity was noted. A mass consistent with a hydatid cyst was noted at segment II of the liver with a tear on the inferior surface. Thus, intraperitoneal rupture of hepatic hydatid cyst was diagnosed.

Conclusion

The rupture of hydatid cyst into the peritoneal cavity is rare but presents a challenge for the radiologist and the surgeon. This condition is included in the differential diagnosis of ascites in endemic areas.

【 授权许可】

   
2014 Limeme et al.; licensee BioMed Central Ltd.

【 图 表 】

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