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Hydatid cyst fistula into the aorta
E Viver1, L Bianchi, J M Callejas
1Hospital Germans Trias i Pujol, Barcelona, Spain.
Insights
This case report details a rare hydatid cyst complication: a fistula directly connecting to the abdominal aorta. Despite surgical intervention, the patient experienced a fatal re-bleeding event.
Area of Science:
- Vascular Surgery
- Parasitology
- Gastroenterology
Background:
- Hydatid cysts, typically caused by Echinococcus granulosus, commonly affect the liver and lungs.
- Aorto-enteric fistulas are rare but serious complications, often associated with abdominal aortic aneurysms.
- This report focuses on an unusual presentation involving a primary hydatid cyst and the aorta.
Observation:
- A patient presented with symptoms suggestive of a coeliac trunk aneurysm.
- Intraoperative findings revealed a hydatid cyst with an unusual fistula directly communicating with the abdominal aorta.
- The surgical team performed a partial resection and closed the aortic communication.
Findings:
- The initial surgical management successfully addressed the hydatid cyst-aorta fistula.
- However, the patient experienced a recurrent bleeding episode three months post-surgery.
- This re-bleeding event ultimately proved fatal.
Implications:
- This case highlights the potential for hydatid cysts to directly involve major vascular structures like the aorta.
- It underscores the critical need for high clinical suspicion and thorough diagnostic workup in endemic areas.
- The fatal outcome emphasizes the challenges and potential severity of managing rare aorto-enteric fistula complications, even after initial surgical success.
Abstract:
A case is presented of fistula formation between a primary hydatid cyst and the abdominal aorta which we believe is the first in the world literature. The patient underwent surgery with a diagnosis of aneurysm of the coeliac trunk. During the operation the presence was discovered of a hydatid cyst opening into the aorta. It was dealt with by partial resection and closing of the communication. Three months later the patient was readmitted with a new bleeding episode which resulted in a fatal outcome.