title: [Acute rupture of hydatid cysts in the peritoneum: 17 cases].
abstract: OBJECTIVE
  Specify the clinical and progressive characteristics of acute rupture of hydatid cysts in the peritoneum.
  
  
  METHODS
  We retrospectively studied patients who had undergone surgery for a hydatid cyst (HC) of the abdomen between January 1990 and December 2000 and in whom the exploration had confirmed the diagnosis of acute rupture of a hydatid cyst in the peritoneum.
  
  
  RESULTS
  Over this period of 11 Years, 970 patients had undergone surgery for hydatid cysts of the liver and the spleen, 17 of whom had presented an acute rupture of the hydatid cyst in the peritoneum, that is to say 1.75% of the cases. The mean age was 30 Years and sex ratio was 0.41. Rupture was secondary to a trauma in 6 cases and to an intense physical effort in one case. The clinical table was acute peritonitis in 14 cases, acute intestinal occlusion in one case, suggested anaphylactic shock in one case, and a non-complicated hydatid cyst in one case. Ultra-sonographic diagnosis was made in all the cases, but that of rupture in 12 cases only. No scans were performed. Intervention was decided on within a delay of less than 72 hours in 16 cases. Surgical treatment consisted in the treatment of the peritonitis, the ruptured hydatid cyst, the associated hydatid cysts in the liver and the spleen, and the hydatid cyst of the right lung in two cases. Post-operative follow-up was complicated in 4 cases with two deaths through septic shock. Distant follow-up was marked by a secondary peritoneal hydatidosis in a patient whom has not benefited from medical treatment. The latter, based on albendazole, was prescribed in 6 patients with satisfying results and a mean follow-up of 32 months.
  
  
  CONCLUSIONS
  The therapeutic progress has improved the prognosis of ruptured hydatid cysts in the peritoneum. Secondary peritoneal hydatidosis is fundamentally enhanced by the delay in diagnosis and treatment and the absence of medical treatment. The optimal strategy is to treat the patients at the non-complicated stage of the hydatid cyst and, above all, prevent the hydatid infestation.
authors.affiliation: Service de chirurgie générale et digestive, EPS Habib Bourguiba, Sfax, Tunisie.
authors.forename: Mohamed Issam
authors.initials: MI
authors.lastname: Beyrouti
authors.forename: Ramez
authors.initials: R
authors.lastname: Beyrouti
authors.forename: Imed
authors.initials: I
authors.lastname: Abbes
authors.forename: Madiha
authors.initials: M
authors.lastname: Kharrat
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ben Amar
authors.forename: Foued
authors.initials: F
authors.lastname: Frikha
authors.forename: Slim
authors.initials: S
authors.lastname: Elleuch
authors.forename: Walid
authors.initials: W
authors.lastname: Gharbi
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chaabouni
authors.forename: Ali
authors.initials: A
authors.lastname: Ghorbel
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004443:Echinococcosis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D004444:Echinococcosis, Hepatic / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004445:Echinococcosis, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010537:Peritoneum; D010538:Peritonitis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D012421:Rupture; D012422:Rupture, Spontaneous; D013158:Splenic Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013161:Splenic Rupture / Q000209:etiology; D014463:Ultrasonography
chemical_list: D000871:Anthelmintics; D015766:Albendazole