Peritoneal Hydatidosis: A Case-Based Discussion and Management Strategies

This report presents the case of a 58-year-old male labourer from Kasur, Pakistan, with abdominal pain for two years, abdominal distension for one month, and altered bowel habits for six months. He had no comorbidities or reported exposure to dogs or sheep. Clinical examination revealed abdominal tenderness and percussion dullness. Laboratory investigations revealed haemoglobin of 11 g/dL, total leukocyte count of 9.6 × 10³/µL, and elevated Echinococcus IgG antibodies. Ultrasound and CT scans showed multiple hepatic, splenic, and peritoneal hydatid cysts, with characteristic honeycomb and spoke-wheel appearances. A large calcified cyst was noted inferior to the liver. The patient was treated with Albendazole. After three cycles of treatment, peritoneal cysts regressed significantly, while hepatic cysts persisted. Follow-up imaging confirmed disease regression, and surgical intervention was not required. This case illustrates a rare occurrence of peritoneal hydatidosis in Pakistan, emphasising the need for early recognition, accurate radiological diagnosis, and appropriate medical management. In resource-limited settings, albendazole therapy can yield favourable outcomes, reducing the need for surgery.