A rare complication of the hepatic hydatid cyst: intraperitoneal perforation without anaphylaxis.
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.
Di Cataldo
Antonio
A
University of Catania, Catania, Italy. dicataldoa@tiscalinet.it
Lanteri
Raffaele
R
Caniglia
Stefania
S
Santangelo
Marco
M
Occhipinti
Rosario
R
Li Destri
Giovanni
G
D001658:Biliary Fistula / Q000628:therapy; D004444:Echinococcosis, Hepatic / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000469:parasitology*; D012422:Rupture, Spontaneous; D016717:Sphincterotomy, Endoscopic