The hepatic hydatid cyst can lead to serious complications as a perforation into the biliary system or into the respiratory tract. The perforation into the peritoneal cavity can become dramatic, characterized by acute abdomen, usually with anaphylaxis. We recently treated a patient with a liver hydatid cyst perforated into the abdominal cavity. Computed tomography was a useful diagnostic tool, and the patient underwent emergency surgery. At laparotomy, 8 liters of hydatid liquid with floating daughter cysts and purulent material was found. The peritoneal cavity was washed with hypertonic solution, the hepatic cyst with daughter cysts was removed, and a subtotal pericystectomy was performed. The critical clinical picture did not allow a cholecystectomy or a probe of the common hepatic duct to verify a biliary leakage. A biliary fistula appeared after 4 days and was successfully treated by endoscopic sphincterotomy. No anaphylactic phenomena were seen, probably because the great quantity of purulent material caused inactivity of the allergic component.
A rare complication of the hepatic hydatid cyst: intraperitoneal perforation without anaphylaxis
DI CATALDO, Antonio;LI DESTRI, Giovanni
2005-01-01
Abstract
The hepatic hydatid cyst can lead to serious complications as a perforation into the biliary system or into the respiratory tract. The perforation into the peritoneal cavity can become dramatic, characterized by acute abdomen, usually with anaphylaxis. We recently treated a patient with a liver hydatid cyst perforated into the abdominal cavity. Computed tomography was a useful diagnostic tool, and the patient underwent emergency surgery. At laparotomy, 8 liters of hydatid liquid with floating daughter cysts and purulent material was found. The peritoneal cavity was washed with hypertonic solution, the hepatic cyst with daughter cysts was removed, and a subtotal pericystectomy was performed. The critical clinical picture did not allow a cholecystectomy or a probe of the common hepatic duct to verify a biliary leakage. A biliary fistula appeared after 4 days and was successfully treated by endoscopic sphincterotomy. No anaphylactic phenomena were seen, probably because the great quantity of purulent material caused inactivity of the allergic component.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.