Abstract
Hydatid disease is rare; nevertheless, several areas of the world are endemic. Lebanon is one of the endemic countries. This disease requires careful management, as its diagnosis is tough, and its complications are severe and can lead to sudden death. These complications include fistulas, infection, and rupture. Rupture of a hydatid cyst can mimic acute abdomen and show an array of nonspecific symptoms. It could be mistaken for hemorrhagic shock, trauma, or injury to an intra-abdominal organ. The diagnosis of ruptured hydatid cyst should be kept in mind in cattle-raising countries. We report the case of a polytrauma patient who was suspected to have severe intra-abdominal bleeding and hemorrhagic shock, but imaging and laparotomy showed the rupture of a liver hydatid cyst that drove the patient into anaphylactic shock. This article reviews similar cases in the literature and discusses the diagnostic tools, appropriate management, and expected complications.
Highlights
Case PresentationA total body computed tomography (CT) was ordered to rule out head injury, intracranial bleed, and intra-abdominal bleed
Hydatid disease is rare; several areas of the world are endemic
We report the case of a polytrauma patient who was suspected to have severe intraabdominal bleeding and hemorrhagic shock, but imaging and laparotomy showed the rupture of a liver hydatid cyst that drove the patient into anaphylactic shock
Summary
A total body computed tomography (CT) was ordered to rule out head injury, intracranial bleed, and intra-abdominal bleed His laboratories were significant for: hemoglobin (Hb) 20 g/dL, white blood cell (WBC) 8800 m/mm[3] with N 35% and L 60%; everything else was within normal range. CT of the abdomen and pelvis showed (►Fig. 1) a heterogeneous liver lesion in segment VII, measuring 60 mm along its largest axis. Trauma-Induced Rupture of Liver Hydatid Cyst Khaled and Kachi e349 regular floor He was soon started on normal diet. Drains’ output showed no bile leak, and the patient was discharged 1 week postop after removing the drains He was given a prescription for albendazole to be taken over the following 6 months. He was referred to an infectious disease specialist for follow-up
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