Treatment of a Large Gluteal Hydatid Cyst in Syria Using a Manual Negative Pressure Wound Therapy Device (PragmaVAC)

The lungs and liver are the most common sites of hydatid cysts, but they may also be found in other organs. We report the case of a lady in her 50s who presented to a hospital in northwest Syria with a large swelling in the right gluteal region. This was diagnosed as a gluteal abscess, and an incision and drainage were performed. Intraoperatively, a hydatid cyst germinal membrane was noted. She had the required imaging to exclude other cysts, which revealed a liver hydatid cyst of 7.5 cm, which was treated with PAIR (puncture, aspiration, injection, and re-aspiration) and albendazole. The residual wound was closed using a manual vacuum-assisted closure (VAC) pump for seven days. A key lesson is that a hydatid cyst in the gluteal muscles, though rare, should be considered in the differential diagnosis. We also show that the innovative use of a manual VAC pump can be used to support closure of large hydatid cyst cavities in muscles.