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Hepatic hydatid cyst rupturing into sub-diaphragmatic space and pericardial cavity
S R Ahuja1, S Karande, S R Koteyar
1Department of Paediatrics, LTM Medical College and LTMG Hospital, Sion, Mumbai - 400 022, India.
Insights
A ruptured hepatic hydatid cyst caused pericardial effusion in a child. Medical management with albendazole successfully treated both pericardial and pleural effusions without surgery.
Area of Science:
- Cardiology
- Parasitology
- Pediatric Surgery
Background:
- Hydatid cysts, caused by Echinococcus granulosus, commonly affect the liver.
- Rupture of hepatic hydatid cysts can lead to serious complications, including dissemination of protoscolices.
- Pericardial involvement from hepatic hydatid cysts is rare but potentially life-threatening.
Observation:
- A ten-year-old male presented with a large hepatic hydatid cyst.
- The cyst ruptured into the sub-diaphragmatic space and pericardial cavity, causing a pericardial effusion.
- Computerised tomographic scan confirmed the communication between the cyst and the pericardium.
Findings:
- The hepatic hydatid cyst was successfully aspirated and enucleated.
- A right-sided reactionary pleural effusion was also noted.
- Albendazole therapy led to the resolution of both pericardial and pleural effusions.
Implications:
- This case highlights the importance of considering hydatid cyst rupture in the differential diagnosis of pericardial effusion, especially in endemic areas.
- Conservative management with albendazole may be effective in resolving effusions secondary to ruptured hepatic hydatid cysts.
- Minimally invasive approaches and medical therapy can avoid surgical intervention in select cases of complicated hydatid disease.
Abstract:
A ten-year-old male child presented with a large hepatic hydatid cyst which ruptured into the sub-diaphragmatic space and pericardial cavity, giving rise to a pericardial effusion. This communication between the hydatid cyst and the pericardium was documented on computerised tomographic scan of the chest and abdomen. The cyst was aspirated carefully and then enucleated. There was an associated right-sided reactionary pleural effusion. The pericardial effusion and pleural effusion resolved on albendazole therapy and did not require surgical intervention.