Rupture Of Hepatic Hydatid Cyst Research Articles

INTRAPLEURAL RUPTURED HYDATID CYST OF LIVER PRESENTED AS EOSINOPHILIC PLEURAL EFFUSION: CASE REPORT

Eosinophilic pleural effusions (EPE) are rare with an estimated incidence of 7.2% of all pleural effusions. EPE due to echinococcosis is exceptionally described in the literature. Pleural echinococcosis is almost always secondary to a ruptured primary lung cyst. Intrathoracic rupture of hepatic hydatid cyst (HC) is a rare clinical entity the rupture into the pleural cavity is less common than in the bronchial tree. We report a case of a 72 year old patient, presented with dyspnea, the chest X-ray showed a right-sided pleural effusion. The initial diagnostic process included two thoracentesis which yield eosinophilic pleural effusions. A transthoracic ultrasound showed cystic formations in the pleura, in addition to an abdominal collection with classic ultrasound images of water-lily sign and serpent sign. CT features suggested ruptured hepatic hydatid cyst in the pleura. Surgical intervention was indicated with postoperative chemotherapy.

ЭНДОСКОПИЧЕСКАЯ ДИАГНОСТИКА И ЛЕЧЕНИЕ ПРОРЫВА ЭХИНОКОККОВОЙ КИСТЫ ПЕЧЕНИ В ЖЁЛЧНЫЕ ХОДЫ

Hepatic echinococcosis (HE), also known as hydatid disease in humans, is a parasitic disease prevalent in countries with a developed animal husbandry industry. The parasite mainly impacts the liver and lungs of an individual and presents itself as a cyst. Severe complications of HE are suppuration, communicating rupture of hepatic hydatid cysts (HHC) into the abdominal or pleural (through the diaphragm) cavities, adjacent hollow organs, and bile ducts. In the latter case, the ducts are blocked by HHC elements with the development of obstructive jaundice (OJ). The article presents a rare clinical case of successful treatment of a patient with HHC, complicated by a communicating rupture of hepatic hydatid cysts into the biliary tract and the development of OJ. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP), endoscopic papillosphincterotomy (EPST), chitin coat extraction, and mechanical block elimination with biliary tract lavage. Keywords: Hepatic echinococcosis, communicating rupture into the bile ducts, obstructive jaundice, endoscopic retrograde cholangiopancreatography, papillosphincterotomy, chitin coat extraction.

Hydatid cysts of liver with secondary peritoneal hydatidosis- a case report

secondary peritoneal hydatidosis constitutes about 10-16% cases of hydatid disease and occurs secondary to rupture of hepatic hydatid cysts which can be spontaneous or due to traumatic rupture.Imaging plays an important role in diagnosing secondary peritoneal hydatidosis as most of the cases are asymptomatic and present later due to mass effect characteristic imaging findings like presence of daughter cysts ,membranes ,hydatid sand and presence of multiloculated cysts helps in diagnosing hydatid cysts.Although liver and lung are most common organs affected by hydatid disease ,disseminated hydatidosis is also seen of which primary peritoneal hydatidosis is rare constituting only 2% of cases

Our experiences in 1000 case single-centre endoscopic retrograde cholangiopancreatography.

Endoscopic retrograde cholangiopancreatography (ERCP) has a very important role in both diagnosis and treatment of pancreaticobiliary pathologies. The aim of this study was to review the indications, technical success complications and results of ERCP procedures performed in our centre. In the study, the data of 1000 patients who were diagnosed with extrahepatic cholestasis, obstructive cholangitis/pancreatitis or bile leakage in clinical, medical and radiological data and who underwent ERCP between May 2019 and November 2021 were evaluated retrospectively. The age distribution was between 14 and 109 years, and the average age was 57.97 years for women (14-109) and 57.48 for men (19-95). Gender distribution was as follows: 552 (55.2%) women and 448 (44.8%) men. ERCP indications in this study were as follows: choledocholithiasis, malignant bile duct obstruction, odysphincter dysfunction (ODS), post-operative bile leakage, hepatic hydatid cyst rupture into the biliary tract and bile duct stenosis. Eight hundred and seventy-one (87.1%) patients had common bile duct stones, 30 (3%) pancreatic head tumour, 22 (2.2%) common bile duct tumour and 20 (2%) cholestasis due to papilla tumour and/or obstructive icterus. Twenty-two (2.2%) patients were treated for sphincter dysfunction (ODS) of Oddi. ERCP was performed in 12 (1.2%) patients with the diagnosis of bile leakage after liver hydatid surgery, 10 (1%) after gall bladder surgery and 8 (0.8%) with the diagnosis of biliary tract stenosis after gall bladder surgery. ERCP was performed in 5 (0.5%) patients due to biliary tract obstruction as a result of rupture of hydatid liver cyst into the biliary tract. Successful cannulation was achieved in 1000 patients listed. Ninety-seven patients who were included in the ERCP procedure but could not be cannulated were not included in the study. Endoscopic sphincterotomy was performed on all patients in the ERCP procedure. In patients with choledochal stones, stone extraction from the common bile duct and/or plastic stent placement in the common bile duct was added. Plastic stent was placed in the common bile duct in patients with pancreatic head tumour, common bile duct tumour, bile duct leakage and common choledochal stenosis. Endoscopic biopsy was taken from all patients with suspected papillary tumour. The processing time varied between 15 and 90 min. The overall complication rate was 17.4%. After ERCP, 93 patients developed amylasaemia that did not require treatment, while 50 patients were diagnosed with clinical and laboratory acute pancreatitis. Intraoperative bleeding, which did not require blood transfusion and could be controlled with adrenaline injection and/or balloon pressure, developed in 10 patients. In one patient, basket and stone were stuck in the papilla during stone extraction. There was no operative mortality. ERCP is a complex procedure that uses special equipment and must be performed by experienced specialists. To increase the reliability of the ERCP procedure, it is necessary to determine the risk factors for ERCP complications very well. Unnecessary ERCP should be avoided. ERCP should not be performed, especially in patients with low probability of stone or stricture, patients with normal bilirubin and patients who do not show other signs of biliary disease. The use of non-invasive imaging methods as much as possible instead of diagnostic ERCP will reduce the complications associated with ERCP.

Multiple Fat- Containing Hepatic Hydatid Cysts: A Case Report in The X- Ray Institute at Medical City Health Directorate in Iraq

Background: Hydatidosis is a zoonotic disease caused by Echinococcus granulosus and Echinococcus multilocularis parasite which is still endemic in many countries all over the world especially in the developing countries. The liver is the primary site to be infested by the parasite with a rate of 60 – 75%. The right lobe of the liver gets infected in about 80% of cases. Hydatid disease of the liver is usually asymptomatic and most cases discovered accidentally on routine clinical or radiological examinations for other illness. Symptoms usually appear in complicated cases either due to rupture, secondary bacterial infection, or due to the large size of the cyst which might cause pain in the right upper quadrant of the abdomen, discomfort, and sometimes swelling. In this case report, we reported the presence of fat globules within the hepatic hydatid cysts which is most probably due to rupture of hepatic hydatid cysts into the biliary tree. Keywords: Hepatic, hydatid cyst, fat globule and CT scan

Acute intraperitoneal rupture of hydatid cysts of the liver: Case series.

Hydatid cyst is a parasitic infection caused mainly by Echinococcus granulosus, which is generally considered benign. However, the hepatic hydatid cyst rupture in the abdominal cavity is a life-threatening incident that requires urgent and multidisciplinary management (emergency physicians, radiologists, anesthetists, and surgeons). This study describes clinical and paraclinical liver hydatid cyst rupture in the peritoneal cavity and details the appropriate treatment.A retrospective review of clinical records of patients hospitalized in Jendouba Hospital for liver hydatid cyst was performed over 8 years, from January 1, 2012 to December 31, 2019. Fifteen cases of liver hydatid cyst complicated with acute rupture into the abdominal cavity were collected out of 625 hydatid liver cysts. All patients underwent emergency laparotomy allowing conservative unroofing procedure associated with peritoneal lavage and external drainage combined with necessary intensive care measures. Clinical features, therapeutic procedures’ details as well as postoperative outcomes are reported. Statistical analysis was performed using the Statistical Package for the Social Sciences for Windows version 20.There were 9 men and 6 women. Patients’ age ranged from 14 to 59 years, with an average of 38 years. Two patients were admitted with abdominal trauma. Acute abdominal pain was the most common complaint. Only 1 patient had an anaphylactic shock. Abdominal ultrasonography and computed tomography scan showed discontinuous cyst wall associated to intraperitoneal fluid in all cases. Intraoperatively, the intraperitoneal effusion was clear in 13 cases and purulent in 2. All patients underwent unroofing procedures associated with intra-operative peritoneal lavage and external drainage. The mean hospital stay was 6.11 days, and the mean follow-up was 19 months. No case of recurrence was reported among the patients.In endemic areas, rupture of a hepatic hydatid cyst in the abdominal cavity should be considered in every case of acute abdominal pain, especially if associated with anaphylaxis signs. Early management starting in the emergency room is needed to ensure good outcome.

Management of a hepatic hydatid cyst ruptured into the retroperitoneum and the abdominal wall muscles: A case report

Introduction. Hydatid disease is a zoonosis caused by the tapeworm Echinococcus granulosus. The liver is the most commonly involved organ, followed by lungs. The most common complications of hepatic hydatid cyst are rupture into the biliary tract and secondary bacterial infection. However, rupture into the retroperitoneum and the abdominal wall muscles is exceptional. Case presentation. We describe an unusual case of a 27-year-old female who was referred to our department for right flank pain for four months. Abdominal ultrasound and CT scan revealed a huge hydatid cyst in liver segment VI fistulizing to the retroperitoneum and the lateral and posterior abdominal wall muscles, causing anterior displacement of the right kidney, with two other cysts in segment II and VIII. Surgery was performed associated with perioperative antiparasitic chemotherapy. The cysts were unroofed and a resection of the protruding domes was performed. The hydatid material in the retroperitoneum and the muscles were completely evacuated by aspiration. Follow-up showed no recurrence. Discussion. Hepatic hydatid cyst rupture usually occurs into biliary tract, pleural cavity, bronchial tree and intraperitoneal cavity. Rupture into the retroperitoneum and the lateral and posterior abdominal wall muscles is exceptional. To our knowledge, this complication has never been documented before. The hydatid disease may involve insidiously for a long time to lead to such a complication. Surgery was inevitable in our case. It allowed to treat both the hydatid cyst and its complication. Conclusions. A rupture into the retroperitoneum and the abdominal wall muscles as a complication of a liver hydatid cyst is exceptional. In this presentation, we noticed that hydatid cysts can reach an extremely large size while remaining for a long time asymptomatic. We aim to highlight the significance of preventive measures and public health education to fight against the hydatid disease in endemic areas.

Intrathoracic rupture of hydatid cyst of the liver in children: a report of two cases

BackgroundIntrathoracic rupture of hepatic hydatid cyst is a rare but dangerous complication. Its occurrence in children is exceptional as diagnosis and management constitute real challenges. We report two cases of intrathoracic rupture of hepatic hydatid cyst in children.Case presentationOur patients were respectively 12-year-old boy and 9-year-old girl, known cases of respiratory symptoms, diagnosed initially for pleuropneumonia. The CT scan established the diagnosis of intrathoracic rupture of hepatic hydatid cyst in the pleural cavity for the first patient and in the bronchial tree for the second. An emergency surgery was performed for both. The second patient developed broncho-biliary fistulas during the post-operative course which necessitated a re-intervention. A recurrence was noted at follow-up for the second patient.ConclusionIntrathoracic rupture of hepatic hydatid cyst is a serious complication which can occur even in children. Its diagnosis needs a high index of suspicion. The surgical approach remains controversial and there is a lack of consensus about the best way of management. Recurrence may occur despite appropriate treatment.

Intrabiliary and abdominal rupture of hepatic hydatid cyst leading to biliary obstruction, cholangitis, pancreatitis, peritonitis and septicemia: a case report

BackgroundHydatid cysts are fluid-filled sacs containing immature forms of parastic tapeworms of the genus Echinococcus. The most prevalent and serious complication of hydatid disease is intrabiliary rupture, also known as cystobiliary fistulae. In this study, a sporadic case of biliary obstruction, cholangitis, and septicemia is described secondary to hydatid cyst rupture into the common bile duct and intraperitoneal cavity.Case presentationA 21-year-old Iranian man was admitted to the emergency ward with 5 days of serious sickness and a history of right upper quadrant abdominal pain, fatigue, fever, icterus, vomiting, and no appetite. In the physical examination, abdominal tenderness was detected in all four quadrants and in the scleral icterus. Abdominal ultrasound revealed intrahepatic and extrahepatic biliary duct dilation. Gallbladder wall thickening was normal but was very dilated, and large unilocular intact hepatic cysts were detected in segment IV and another one segment II which had detached laminated membranes and was a ruptured or complicated liver cyst.ConclusionIntrabiliary perforation of the liver hydatid cyst is an infrequent event but has severe consequences. Therefore, when patients complain of abdominal pain, fever, peritonitis, decreased appetite, and jaundice, a differential diagnosis of hydatid disease needs to be taken into consideration. Early diagnosis of complications and aggressive treatments, such as endoscopic retrograde cholangiopancreatography and surgery, are vital.

Intraperitoneal rupture of liver hydatid cyst, a Post sleeve gastrectomy unusual presentation: a case report

Background The asymptomatic clinical presentation of hydatid cysts is the usual picture of presentations, and the cysts are incidentally discovered during radiological examination for other reasons. However, some patients develop symptoms and complications depending on cyst size, location, and the relationships between the cysts and the neighboring structures. Most dangerous complications consist of perforation of the cysts into the adjacent structures like a biliary tree, major vessels, hollow viscera, and peritoneal cavity. Herein, we aimed in this case report to describe the laparoscopic assessment and treatment of a case with an unusual presentation of intraperitoneal rupture of hepatic hydatid cyst after weight loss (post-sleeve gastrectomy) accompanied with review article. Case summary A female patient aged 44 was presented to our hospital with abdominal pain, diarrhea, and hypotension. The perforated cyst was located in the liver. Cyst rupture developed spontaneously. Enzyme-linked immunosorbent assay IgG result was negative. The patient received urgent resuscitation immediately and albendazole treatment was started 2 days before laparoscopic surgical intervention. No recurrence during postoperative follow-up (4 months). Conclusion Intraperitoneal perforation is a rare and severe life-threatening complication of hydatid cysts that can happen after significant weight loss. It is very crucial to treat the patients with appropriate emergent surgical management (including laparoscopy) as rapidly as possible after judicious medical treatment for allergic reactions.

Complicated Hepatic Hydatid Cysts with Rupture into the Biliary Ducts

Introduction: Liver echinococcosis is an endemic disease in the Republic of North Macedonia. The liver is the most frequent site of involvement accounts for 65-75% of cases. Rupture of a hydatid cyst into the biliary tree is the most common complication, occurring in 5-25% of patients. Aim of this research work is to present the important role of radiological imaging examinations in diagnosis of this parasitic infection, and it is complications including rupture of hepatic hydatid cysts into the biliary tree. Case presentation: We are presenting a female 68-year-old patient, with obstructive jaundice, right subcostal pain, nausea, vomiting, fatigue, and weight loss. Ultra Sound (US) and Computed Tomography (CT) examinations are perform and we found two suppurated hydatid cysts in the liver, with a diameter between 65 and 105 mm. One of them penetrated the biliary system creating a fistula. The gallbladder was chronically inflamed, filled with gallstones, and with a thickened wall. The patient underwent surgery and the hydatid cysts and gallbladder had completely removed, and the continuity of the biliary stem was established. Conclusion: The postoperative finding completely matched the preoperative US and CT diagnosis. Cysto-biliary communication is more common in large cyst size, located in the central segments of the liver close to the biliary confluence. The postoperative finding completely matched the preoperative US and CT diagnosis.

Hydatid Cyst Rupture After a Blunt Liver Trauma Presented with Diffuse Urticaria: An Unusual Case

We report an unusual case: a 37-year-old-female who was presented to the emergency department with acute generalized urticaria and underwent urgent laparotomy with provisional diagnosis of anaphylaxis secondary to hepatic hydatid cyst rupture due to abdominal trauma, which was diagnosed preoperatively on abdominal computed tomography scan.

Isolated polycystic liver disease revealed by surgical acute abdominal syndrome

A 65 year old woman presented with acute abdomen pain, a history of chronic abdominal swelling. Physical examination found a palpable mass of the right upper quadrant extended to the umbilical quadrant, associated to generalized abdominal tenderness. Laboratory testes demonstrated an inflammatory syndrome without perturbation of serum enzymes of cholestasis. A computed tomography scan of the abdomen revealed more than 20 liver cysts, the biggest measured 20 cm. The biliary tree and the kidneys were normal. It also showed an intraperitoneal effusion. We suspected a spontaneous rupture of hepatic hydatid cysts despite negative hydatid serology. The patient was operated upon electively and the operative findings were a polycystic liver spread through several segments of the liver with a giant thin walled cyst of the right lobe measured 20cm associated to a free fluid in the hepato-diaphragmatic space, without biliary fistula. We performed the fenestration technique which combined aspiration of 4 liters of serous fluid and chocolate-like materials and deroofing of the biggest cyst. The histology has confirmed the diagnosis of a simple hepatic cyst. The outcome until 11 months after still uneventful.

Endoscopic ultrasound of bile duct hydatid membrane

Background:Hepatic hydatid cyst rupture into the bile ducts (intrabiliary rupture) is the most common and serious complication of hepatic hydatid disease, occurring in 2%–42% of cases. Intrabiliary rupture (IBR) can be diagnosed by ultrasonography, computerized tomography, or magnetic resonance imaging.Methods:Transabdominal ultrasonography showed a 3.2 cm × 3.4 cm cyst in the right lobe of the liver, dilatation of the biliary system up to the lower end of the common bile duct (CBD), and biliary sludge in the gallbladder. Linear EUS was performed before endoscopic retrograde cholangiopancreatography (ERCP) to know the etiology of cholangitis.Results:Linear EUS from stomach revealed multiple curvilinear, leaflet-shaped, rounded, and irregular structures within dilated CBD and common hepatic duct. These structures were hyperechoic, multilayered, with intervening anechoic areas without acoustic shadowing indicating membranous structures folded many times. The structures were floating inside the CBD suggestive of hydatid membranes. Cholangiogram revealed a dilated CBD with multiple irregular filling defects formed by the hydatid membranes. ERCP with biliary sphincterotomy and balloon sweeping resulted in CBD clearance with expulsion of the multiple bile stained and whitish hydatid membranes. There was a significant improvement in clinical condition after ERCP. Follow-up USG after 2 weeks revealed normal CBD with decreased size of liver cyst.Conclusions:EUS by demonstrating the presence of mobile hydatid membranes or cyst-like material may be useful when other imaging modalities are inconclusive or unavailable in IBR. ERCP is both diagnostic and therapeutic in IBR, with removal of hydatid membranes relieving jaundice and cholangitis.

ERCP treatment for intrabiliary rupture of hepatic hydatid cyst in a child

In this report, we present a patient with intrabiliary rupture of a hydatid cyst, which caused choledochal obstruction and treated with endoscopic retrograde cholangiopancreatography (ERCP). It is an emergency and treated with mini - mally invasive surgery. A twelve-year-old female patient with acute upper ab - dominal pain, nausea, and vomiting was admitted to pediatric surgery clinic with the preliminary diagnosis of cholestasis. There were localized right upper abdominal rebound and tenderness. Contrast-enhanced axial computed tomog - raphy images through the liver showed that there was a cystic lesion in segment 4 communicating with the biliary system. The main hepatic duct was obliterat - ed and dilated by curvilinear densities consistent with germinative membranes expelled from the cyst into the biliary system. ERCP and sphincterotomy were performed. Germinative membrane and daughter cysts were cleaned with the use of balloon and basket. The patient is doing well without any other complica - tion 20 months after ERCP. There have been few case reports documenting the successful use of ERCP treatment of hydatid cyst. ERCP may be a useful pro - cedure in selected children with suspected intrabiliary rupture or common bile duct obstruction, which occurs due to daughter cyst and germinative membrane.

Rupture of Liver Hydatid Cyst into Gall Bladder

Hepatic hydatid cyst is a rare parasitic affection which constitutes a major health problem in countries endemic to hydatidosis. Rupture of hydatid cyst into gallbladder is an exceptional complication first described in 1952 by Atlas and Kamenear. We report the case of a hepatic hydatid cyst rupture into gallbladder in a 31-year-old patient with no history of disease.

PO-0906 Intraperitoneal Rupture Of Hepatic Hydatid Cyst Following Blunt Abdominal Trauma In A 7-year-old Boy

<h3>Background</h3> Although Hydatid liver disease may be asymptomatic, one complication of Hydatid disease is perforation of the cyst into the peritoneal cavity after trauma. We present herein a case presented after trauma and had a diagnosis of Hydatid cyst rupture into the peritoneum previously asymptomatic boy. <h3>Case</h3> A 7-year-old boy presented with mild abdominal pain for 6 h. His parents told that his abdominal pain was suddenly commenced after falling down from swing when playing at the playground. They also complained of itching on the whole body starting soon after the trauma. His blood pressure was 90/60 mmHg, heart rate 118/min, and temperature 37.0°C. On the physical examination, urticaria was seen over the thigh and trunk, abdominal examination revealed generalised tenderness. Ultrasonography and computed tomography showed multiple cystic lesions in the liver and one of them had hypoechoic contents and floating echogenic membranesand also free fluid were seen in the pelvis. Intravenous fluids were started followed Hydrocortisone and antihistamine administered along with antibiotic prophylaxis. The patient underwent surgery, 3 cysts at different localization and also a ruptured cyst 4 cm in diameter at the segment 1 were seen. The germinative membranes and the daughter vesicles were removed and abdomen was irrigated with hypertonic saline (3% NaCl). Postoperative albendazole therapy was given for two months. <h3>Conclusion</h3> Rupture of Hydatid cyst should be considered in the differential diagnosis at the presentation of acute abdominal findings with urticaria after abdominal blunt trauma. US and CT are effective in diagnosing of this rare condition.

Isolated hydatid cyst of uterine cervix: A case report

Hydatid disease is an endemic infection which can affect any organ, mainly the liver and lungs. Peritoneal echinococcosis is usually known to occur secondary to hepatic hydatid cyst rupture into the peritoneal cavity. An isolated cyst in the pelvic cavity is considered as primary only when there are no other hydatid cysts. Herein, we report an isolated pelvic-cervical hydatid cyst which presented without any involvement of the other abdominal organs or lungs. Our patient, a 27-year-old woman with the primary complaints of dyspareunia and chronic pelvic pain, had thin-walled large cystic mass originating from the cervix, diagnosed by ultrasonography. She underwent surgery with the most likely initial diagnosis of exophytic fibroid with cystic degeneration. Gynecologists should be aware of the possibility of isolated primary hydatid cyst of the pelvic cavity and should consider this condition in the differential diagnosis of cystic pelvic masses, especially in areas where the disease is endemic.

Intrabiliary rupture of hepatic hydatid cysts: results of 10 years’ experience

Intrabiliary rupture of hepatic hydatid cysts: results of 10 years’ experience

Intrabiliary rupture of hepatic hydatid cyst with impacted hydatid membranes at ampulla of Vater presenting as acute pancreatitis

Intrabiliary rupture of hepatic hydatid cyst with impacted hydatid membranes at ampulla of Vater presenting as acute pancreatitis