Primary Pancreatic Hydatid Disease With Secondary Peritoneal Dissemination Presenting as Acute Abdomen Caused by Cyst Rupture: A Report of a Rare Case.

Hydatid disease is a parasitic infection caused by the cestode Echinococcus granulosus, which most commonly affects the liver due to spread through the portal circulation, but the parasite may also escape into the systemic circulation and involve other organs, such as the pancreas. Pancreatic hydatid cysts can localize in any part of the pancreas, such as the head, body, or tail. Primary localization to the tail of the pancreas with secondary dissemination after an acute cyst rupture can make diagnosis more challenging. Diagnosis is often missed early due to multiple factors, such as low clinical suspicion from an atypical disseminated cyst mass-effect presentation, which can mask pancreatic pathology and possibly mimic urinary pathology, as in our patient. Diagnostic difficulty can also be attributed to the similar appearance that pancreatic hydatid cysts may share with other cystic lesions on imaging. This case report highlights the diagnostic challenges in a rare case of primary pancreatic hydatid disease of the tail with secondary peritoneal dissemination in a 29-year-old African male who presented to the emergency department with generalized abdominal pain and urinary symptoms of dysuria, increased urgency, and frequency. Definitive diagnosis in such cases can be reached with thorough assessment of exposure history and imaging, followed by surgical exploration when indicated and histopathological confirmation.