title: Latent fatality due to hydatid cyst rupture after a severe cough episode.
abstract: Hydatid disease is a parasitic disease caused by Echinococcus granulosus characterised by cyst formation in various organs. The infestation mostly involves the liver. Hydatid cysts of the liver can rupture either spontaneously or due to trauma. Incidence of rupture is about 3-17% of all cases with hydatid disease. Unless treated surgically, rupture can result in death. Here, we present a case of hydatid cyst ruptured after a severe cough episode and disseminated first to the subcapsular area, then to the peritoneal space. Probably due to a decrease in parenchymal pressure in the liver after decompressive effect of rupture, the patient felt an improvement in abdominal pain, refused operation, and left the hospital on his own responsibility. This unfortunate relief resulted in a delay of 55 hours in management. The leakage of liquid materials into peritoneal space resulted in a severe inflammatory reaction and eventually death of the patient. The patient died of a late peritonitis rather than anaphylaxis, which is the most common reason for death in such patients. As a conclusion, physicians should be aware of a temporary relief in abdominal pain after cyst rupture that may cause a delay in management and in turn loss of patient due to peritonitis.
authors.affiliation: Department of Radiology, Abant Izzet Baysal University, Duzce Medical School, Duzce, Turkey. besirerdo@hotmail.com
authors.forename: Besir
authors.initials: B
authors.lastname: Erdogmus
authors.forename: Burhan
authors.initials: B
authors.lastname: Yazici
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Akcan
authors.forename: Betul Ayca
authors.initials: BA
authors.lastname: Ozdere
authors.forename: Ugur
authors.initials: U
authors.lastname: Korkmaz
authors.forename: Aytekin
authors.initials: A
authors.lastname: Alcelik
mesh_terms: D003371:Cough; D004443:Echinococcosis / Q000401:mortality* / Q000473:pathology; D004444:Echinococcosis, Hepatic / Q000401:mortality* / Q000473:pathology; D048209:Echinococcus granulosus / Q000378:metabolism; D017809:Fatal Outcome; D006801:Humans; D007249:Inflammation; D008099:Liver / Q000469:parasitology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010146:Pain; D010538:Peritonitis / Q000401:mortality* / Q000473:pathology; D012421:Rupture; D013997:Time Factors; D014057:Tomography, X-Ray Computed