Intraperitoneal Rupture of Liver Hydatid Cyst: Presented with Sever Right Shoulder and Mild Abdominal Pain - Abstract
Hydatid Disease (HD) can involve all organs of the human body but most often in the liver (77%-50%) and lungs (35%18%). (HD) disease is endemic in certain areas of the world; however, (HC) remains a considerable public health problem in several mediterranean countries. Intraperitoneal cavity rupture is
the most common causes of rupture are result from trauma or may occur spontaneously. The latter form of rupture is due to increased pressure of the cystic fluid. Ruptured hydatid cyst is a rare cause of severe shoulder and abdominal pain but should be considered in the differential diagnosis, especially in endemic
areas. The diagnosis of ruptured hydatid cyst is important, because it requires emergency intervention. Here we present a case of 64 year old Iranian female admitted in our hospital under orthopedic specialty, because of severe right shoulder pain. Physical examination was unremarkable except mild right side
abdominal pain. Chest radiography (CX) showed right side costophrenic angle was blunt. Abdominal ultrasonography showed a small amount of fluid around the liver and three cystic masses in the right and left lobe of liver. Abdominal computed tomography (CT) showed two intact cysts and one ruptured cyst.
Emergency laparotomy was performed. A yellow serous fluid, containing many daughter vesicles and laminated membrane was collected through the peritoneal cavity under the diaphragm and liver. All elements of hydatid cyst were removed and two other intact cysts were evacuated and omentoplasty was performed. Albendazole 800 mg daily was started to day postoperatively. Patient was discharged 6 day post operative with good condition. The rupture of hydatid cyst into the peritoneal cavity is rare but presents a challenge for the radiologist and the surgeon especially in endemic area.