Management of abdomen hydatidosis after rupture of a hydatid splenic cyst: a case report

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Abstract

We present a case of multiple hydatidosis in an 8-year-old boy that resulted from a ruptured hydatid cyst of the spleen and spread into the peritoneal cavity. We also present a new approach for managing these difficult and high-risk cases.

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Acute intraperitoneal rupture of hydatid cysts.

Ali Bozdag, Enver Reyhan, H Derici … (2006)

Rupture into the abdominal cavity is a rare but serious complication of hydatid disease. The cysts may be ruptured after a trauma, or spontaneously as a result of increased intracystic pressure. Rupture of the hydatid cyst requires emergency surgical intervention. Seventeen patients received surgical treatment for intraperitoneal rupture of the cysts over a period of 18 years. Age, gender, time to surgery from the onset of the symptoms, laboratory findings, diagnostic procedures, surgical treatment modalities, in-hospital stay, morbidity, mortality and recurrence were evaluated retrospectively. Five cases (29.4%) had a history of blunt abdominal trauma. Ultrasonography scans revealed intra-abdominal fluid in all cases. Intraperitoneal multiple cysts with heterogeneous cavity or cystic structures in the liver were shown in 14 cases. Computed tomography and magnetic resonance imaging showed multiple cystic lesions in the liver and peritoneum with intra-abdominal free fluid. Procedures to fill the cystic cavities were applied after removal of the intraperitoneal fluid. Four patients (23.5%) died in the early postoperative period. A total of nine morbidities developed in six patients (35.3%). Median hospital stay was 18 days and median follow-up was 78 months. Intra-abdominal recurrence occurred in one case (7.7%). Rupture of hydatid cysts into the peritoneal cavity, although rare, presents a challenge for surgeons. This pathology should be included in the differential diagnosis of acute abdomen in endemic areas. Computed tomography scan, in addition to clinical presentation, is essential for diagnosis. Emergency surgery is the main treatment for acute ruptured hydatid cysts. The morbidity and mortality rates of surgical interventions for ruptured hydatid cysts are higher than the rates for elective uncomplicated cases.

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Efficacy of preoperative albendazole use according to months in hydatid cyst of the liver.

Mehmet Altintas, Nejdet Bildik, M Gülmen … (2007)

Hydatid cyst is still a significant health and economical problem due to insufficient preventive measures. Infestation by hydatid disease in humans most commonly occurs in the liver and causes complications unless treated properly. Therefore, hepatic hydatid cyst should immediately be treated when diagnosed. Today, the treatment of hydatid cysts is principally surgical. To avoid recurrence, viable scoleces in the hydatid cyst should be eliminated before emptying surgically. Length of Albendazole therapy, a drug effective on scoleces in the cyst, is still controversial. In this study, there was a significant difference in the rate of viable scoleces when group III receiving albendazole for 3 months preoperatively was compared with group I, group II, and the control group. We do think 3-month preoperative abendazole treatment is effective in reducing the rate of recurrence and if still viable scoleces are observed in the surgery, albendazole treatment should be continued for 1 month postoperatively. After the therapy, in group I 10 (47.6%), in group II 7 (33.3%), and in group III 2 (0.9%) patient's scoleces were alive. In the control group (group IV) 17 (80%) patients' scoleces were intact. When group III is compared with the control group, a significant difference was observed (P<0.05). Yet again, there was a significant difference between the groups when groups I and II were compared with group III. We concluded that in treatment of hydatid cyst, albendazole should be continued at least for 3 months preoperatively and if still viable scoleces are identified, medical treatment should follow the surgical intervention at least for 1 month to decrease the possibility of residual cysts and recurrence.

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Unusual locations of hydatid disease and surgical approach.

O. Hamamci, H. Besim, Atila Korkmaz (2004)

Hydatid disease is an endemic parasitic disease of the Mediterranean countries. Although the liver is the most commonly involved organ, the disease can be seen anywhere in the body. In the present study, we present our experience with uncommonly located hydatid disease diagnosed and treated between 1983 and 1999 in the Sixth Surgical Department of Ankara Numune Training and Research Hospital, Ankara, Turkey. Forty-nine patients with unusually located hydatid disease were retrospectively analysed. There were 21 men and 28 women in the present series. Of those, 26 patients were harbouring both hepatic and extrahepatic cysts, while 23 had only extrahepatic cysts. Peritoneal cavity, spleen, retroperitoneum, thyroid gland, anterior abdominal wall, thigh, kidney, presacral space and pancreas were the organs or tissues involved in the cases. Spleen and peritoneal cavity were the two most frequent locations in the present series. Partial or total cystectomy with or without tube drainage or omentopexy was the operation of choice for hydatid cyst of the peritoneal cavity. Splenectomy was performed for splenic hydatidosis. Mean postoperative stay was 7 days (4-23). Three diaphragmatic and one inferior vena cava lacerations occurred during operations that were repaired successfully in the same sessions. No mortality occurred in the present series. Hydatid disease can affect any organ or area throughout the body and suspicion of this disease should be justified in patients presenting with a cystic mass in endemic areas.

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Journal

Journal ID (nlm-ta): Cases J

Title: Cases Journal

Publisher: Cases Network Ltd

ISSN (Electronic): 1757-1626

Publication date (Electronic): 02 September 2009

Publication date Collection: 2009

Volume: 2

Electronic Location Identifier: 8416

Affiliations

[1 ]simplePaediatric Surgery Department, University General Hospital of Alexandroupolis Dragana, 68100 AlexandroupolisGreece

[2 ]simpleMicrobiology Laboratory, University General Hospital of Alexandroupolis Dragana, 68100 AlexandroupolisGreece

[3 ]simpleRadiology Department, University General Hospital of Alexandroupolis Dragana, 68100 AlexandroupolisGreece

Article

Publisher ID: 8416

DOI: 10.4076/1757-1626-2-8416

PMC ID: 2769439

PubMed ID: 19918429

SO-VID: 35396b85-0605-4411-8c39-567c86a20ed4

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Management of abdomen hydatidosis after rupture of a hydatid splenic cyst: a case report

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Most cited references 8

Acute intraperitoneal rupture of hydatid cysts.

Efficacy of preoperative albendazole use according to months in hydatid cyst of the liver.

Unusual locations of hydatid disease and surgical approach.

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