Intra-peritoneal rupture of large hydatid cyst of the liver containing innumerable daughter cysts after blunt abdominal trauma.

INTRODUCTION: Hydatid disease is a major health concern in the Mediterranean countries and many other parts of the world. The route of transmission is fecal-oral, and then spread by the portal venous system almost all part of the body. The liver is the most commonly involved organ, followed by the lungs, and other organs are involved in order of decreasing frequency.

PRESENTATION OF CASE: A middle-age male patient presented with acute abdominal pain and repeated vomiting after blunt abdominal trauma. CT-scan showed a large hydatid cyst of the right lobe of the liver with features of intraperitoneal rupture. Emergency laparotomy was performed with extraction of a countless number of daughter cysts from the peritoneal cavity. We further examined the bowel and found no abnormalities. The cyst was not causing any compression on the bile duct. Omentoplasty was performed for the cavity. The patient was discharged home eight days after the operation and the drain removed after twenty-five days when the bile leak stopped, anthelminthic drugs were given for three months after the surgery.

CONCLUSION: Prevention of hydatid disease is the most effective way to control the disease, the cyst may reach a very large size and be asymptomatic. Intraperitoneal rupture may occur as a result of blunt abdominal trauma which could be trivial.