Ruptured Hydatid Cyst of Liver and Huge Pulmonary Hydatid cyst: Presented as Acute Abdomen with Severe Anaphylaxis Shock: A Rare Presentation - Abstract
Hydatid disease can involve various organs of the body and may develop in any organ member But most often in the liver (77%-50%) and lungs (35%-18%), and sometimes in other organs. Liver and hepatic hydatid cysts occur in 25% of cases in 4%. The clinical signs and symptoms of hydatid cyst depend on the locations that are involved (deep or superficial,right or left lobe), size, adjacent organs, and complications such as infection or cyst rupture. Rupture of the cyst may occur after trauma or spontaneously due to suddenly increased intracystic pressure. When a hydatid cyst is broken down in the peritoneum, catastrophic complications such as abdominal pain, chewing gum, anaphylaxis, and sudden death may occur. We have a 40-year-old woman with anaphylactic shock, Such as severe abdominal pain, tachycardia, hypotension and massive erythema, and rapidly intubating and then severely care unit forresuscitation. With the primary suspicion of peritonitis, open laparotomy was performed. During the surgery, hydatid cyst elements were observed within different parts of the abdomen. One ruptured cyst was seen in the posterior of theright lobe of liver which invades to the diaphragm. The cyst cavity was irrigated with saline, pericystectomy and Capi tonnage. The abdominal cavity was washed twice with providing –iodine10% of the solution at 10-minute intervals. One huge cyst was also detected in the upperlobe of right lung on postoperative chest radiography. one week latter patient under went thoracotomy for lung cyst. Patient discharged with good conditions. Conclusion:The rupture of a hydatid cyst into the abdominal cavity is rare and anaphylaxis shock is extremely rare. This condition missed with acute abdomen in endemic areas, especially in young patients and must be in the differential diagnosis of the acute abdomen.