[Hepatic hydatid cyst ruptured in the peritoneum]

Area of Science:

• Hepatology
• Parasitology
• Surgical Pathology

Background:

• Romania has a high incidence of hepatic hydatid cysts.
• Intrabiliary rupture is common, but intraperitoneal rupture is rare.

Purpose of the Study:

• To report on the management and outcomes of intraperitoneal ruptured hepatic hydatid cysts.
• To evaluate the efficacy of hypertonic serum lavage and benzimidazolic drugs in preventing peritoneal seeding.

Main Methods:

• A retrospective review of 160 patients with hepatic hydatid cysts operated between 1993-2002.
• Six patients had intraperitoneal ruptured cysts, diagnosed via ultrasound and intraoperatively.
• Treatment included surgical evacuation, pericyst removal, hypertonic serum lavage, and non-absorbable sutures.

Main Results:

• Six cases of intraperitoneal ruptured hepatic hydatid cysts were identified.
• Ultrasound suspected rupture in 4 cases; one intact cyst was mistaken for an ovarian cyst.
• Postoperative course was uneventful with prophylaxis using benzimidazolic drugs.
• Follow-up (1-4 years) showed no recurrence of peritoneal hydatidosis.

Conclusions:

• Hypertonic serum lavage and benzimidazolic drugs are effective in preventing peritoneal seeding in cases of intraperitoneal ruptured hydatid cysts.
• Prompt diagnosis and appropriate surgical management are crucial for favorable outcomes.