title: Spontaneous intraperitoneal rupture of hepatic hydatid cyst: a rare cause of ascites.
abstract: BACKGROUND
  Hydatid disease is endemic in certain areas of the world and it is located mostly in the liver. Intraperitoneal rupture is rare. Rupture may result from trauma or may occur spontaneously from increased pressure of the cystic fluid. Ruptured hydatid cyst is a rare cause of ascites, but should be considered in the differential diagnosis, especially in endemic areas. The diagnosis of ruptured hydatid cyst should be prompt because it requires emergency intervention.
  
  
  METHODS
  The present case refers to a 62 year old Tunisian male admitted in our institution for diffuse abdominal distension. Physical examination was unremarkable except for the presence of ascites. Abdominal ultrasonography showed a large amount of fluid into the peritoneal cavity associated with many intraperitoneal cysts with a scalloping on the liver. It showed also a heterogeneous cystic lesion of the segment II of the liver. Abdominal computed tomography (CT) revealed in addition a fat infiltration and a thickening of the peritoneum. Thus intraperitoneal hydatid cyst rupture was suspected and emergency laparotomy was performed. A yellow serous fluid , containing many daughter vesicles disseminated through the peritoneal cavity was noted. A mass consistent with a hydatid cyst was noted at segment II of the liver with a tear on the inferior surface. Thus, intraperitoneal rupture of hepatic hydatid cyst was diagnosed.
  
  
  CONCLUSIONS
  The rupture of hydatid cyst into the peritoneal cavity is rare but presents a challenge for the radiologist and the surgeon. This condition is included in the differential diagnosis of ascites in endemic areas.
authors.forename: Manel
authors.initials: M
authors.lastname: Limeme
authors.affiliation: Department of Radiology, Farhat Hached hospital, 4000 Sousse, Tunisia. dr.sana2010@yahoo.fr.
authors.forename: Sana
authors.initials: S
authors.lastname: Yahyaoui
authors.forename: Houneida
authors.initials: H
authors.lastname: Zaghouani
authors.forename: Mosaab
authors.initials: M
authors.lastname: Ghannouchi
authors.forename: Abdelmajid
authors.initials: A
authors.lastname: Khnissi
authors.forename: Habib
authors.initials: H
authors.lastname: Amara
authors.forename: Rached
authors.initials: R
authors.lastname: Letaief
authors.forename: Dejla
authors.initials: D
authors.lastname: Bakir
authors.forename: Chakib
authors.initials: C
authors.lastname: Kraiem
mesh_terms: D001201:Ascites / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D003937:Diagnosis, Differential; D004444:Echinococcosis, Hepatic / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography