Echinococcic pseudotuberculosis of peritoneum

Area of Science:

• Hepatology
• Parasitology
• Abdominal Imaging

Background:

• Hydatid cyst disease, caused by Echinococcus granulosus, is a zoonotic parasitic infection.
• Liver hydatid cysts are the most common presentation, but can mimic other intra-abdominal pathologies.
• Ascites is a common clinical sign with diverse etiologies, including infections and malignancies.

Observation:

• A patient presented with significant ascites, initially suspected to be peritoneal tuberculosis.
• Diagnostic workup revealed a large liver hydatid cyst as the underlying cause of the ascites.
• The clinical presentation and imaging findings mimicked advanced peritoneal disease.

Findings:

• Histopathological examination confirmed the diagnosis of a liver hydatid cyst.
• The cyst's size and location contributed to the peritoneal fluid accumulation.
• Absence of typical tuberculous granulomas on biopsy ruled out peritoneal tuberculosis.

Implications:

• This case underscores the need to include parasitic liver diseases in the differential diagnosis of ascites, especially in endemic areas.
• Accurate diagnosis is crucial to avoid misdiagnosis and ensure appropriate treatment, preventing complications.
• Radiological and clinical vigilance is essential for differentiating hydatid cysts from other causes of ascites.