Intraperitoneal Rupture of a Giant Hydatid Cyst of Liver- Can Emergency Placement of Intraperitoneal Drain Improve Patient Optimisation!

Abstract

Hydatid cyst remains a global health problem. Intraperitoneal hydatid cyst rupture is a life-threatening complication because it causes serious hemodynamic instability and allergic reactions. No clearly defined guidelines exist for dealing with ruptured cysts or intraperitoneal spillage, though emergency exploration remains the standard approach. We present here a case of a 35 -year- old woman who developed spontaneous rupture of a Giant hepatic hydatid cyst. However, patient could not be taken up for emergency surgery in view of very poor chest condition. She was managed by placement of an intra peritoneal drain and lavage with hypertonic saline. Subsequently, patient underwent two surgeries for definitive treatment of the giant hydatid cyst. At one year of follow- up, patient has no evidence of any recurrent disease. Intraperitoneal drain placement and lavage with hypertonic saline may be considered an option to contain peritoneal implantations while patient is being optimised for exploration.