Posttraumatic free intraperitoneal rupture of liver cystic echinococcosis: a case series and review of literature

Am J Surg. 2007 Sep;194(3):313-6. doi: 10.1016/j.amjsurg.2006.11.014.

Abstract

Background: A serious complication of cystic echinococcus (CE) is the rupture of the cysts. Free intra-abdominal rupture occurs in approximately 3.2% of all cases. Posttraumatic rupture of liver CE is very rare.

Methods: The objective of the current study was to evaluate the clinical and radiographic findings and surgical treatment of this complication.

Results: Twenty patients with posttraumatic ruptured liver CE were treated. The incidence rate of hydatid rupture was 3.06%. The common presenting symptom was abdominal pain. All patients were operated on under emergency conditions. There were 26 cysts in 20 patients, and all of the cysts were treated surgically.

Conclusion: Hydatid cyst rupture must be kept in mind in the management of trauma patients with cystic mass in the liver in particular and free intra-abdominal fluid, especially in the endemic area. We preferred conservative (unroofing associated with various procedures for the management of the residual cavity) rather than radical procedures such as hepatic resection or pericystectomy for the surgical treatment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Echinococcosis, Hepatic / complications*
  • Echinococcosis, Hepatic / diagnosis
  • Echinococcosis, Hepatic / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peritoneum
  • Rupture