title: Rupture of liver hydatid cysts into the peritoneal cavity. A challenge in endemic regions.
abstract: OBJECTIVE
  To evaluate the clinical presentation and early and long-term outcomes of patients treated surgically for intraperitoneal ruptured liver hydatid cysts.
  
  
  METHODS
  The medical records of 21 patients with rupture of hydatid cysts were evaluated retrospectively between January 2000 and April 2009 at Izmir Ataturk Training and Research Hospital, Izmir, Turkey, as were the records of 368 patients with hydatid cysts. Age, gender, symptoms, laboratory findings, diagnostic procedures, surgical treatment modalities, in-hospital stay, morbidity, mortality, and recurrence were evaluated.
  
  
  RESULTS
  Sixteen of these patients (76.2%) were women. The mean age was 43.8 years. Cysts were single in 16 cases (76.2%). In 14 cases (66.7%) cysts were localized only in the right lobe. There was also a cyst in the spleen in 4 patients (19%). Simple falls or direct abdominal minor trauma was responsible in 8 patients (38.1%), and pedestrian mishaps in 4 (19%). Nine (42.8%) patients experienced spontaneous rupture. External drainage was performed in 12 (57.1%) patients and omentoplasty in 9 patients (42.8%) to manage the cyst cavity. A total of 11 morbidities developed in 9 patients (42.8%). There was no postoperative mortality. The mean hospital stay was 11.37.4 days, and mean follow-up was 63.131.3 months. The recurrence rate was 23.8%.
  
  
  CONCLUSIONS
  The morbidity and recurrence rates of surgical interventions for ruptured hydatid cysts are high. This pathology, although rare, should be included in the differential diagnosis of an acute abdomen in endemic areas.
authors.affiliation: The 4th General Surgery Clinic, Izmir, Turkey.
authors.forename: Haluk R
authors.initials: HR
authors.lastname: Unalp
authors.forename: Yeliz
authors.initials: Y
authors.lastname: Yilmaz
authors.forename: Evren
authors.initials: E
authors.lastname: Durak
authors.forename: Erdinc
authors.initials: E
authors.lastname: Kamer
authors.forename: Ercument
authors.initials: E
authors.lastname: Tarcan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015766:Albendazole / Q000627:therapeutic use; D000923:Anticestodal Agents / Q000627:therapeutic use; D004444:Echinococcosis, Hepatic / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006801:Humans; D008099:Liver / Q000469:parasitology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity / Q000469:parasitology; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000469:parasitology; D055502:Secondary Prevention; D016896:Treatment Outcome; D014421:Turkey; D055815:Young Adult
chemical_list: D000923:Anticestodal Agents; D015766:Albendazole