Surgical outcomes and management strategies in intraperitoneal rupture of hydatid cysts: A retrospective analysis.

BACKGROUND

Hydatid cyst disease, a parasitic infection caused by Echinococcus species, primarily affects the liver and lungs, with potential for spontaneous or traumatic rupture into the peritoneal cavity. Although hydatid cyst perforation is rare, it necessitates urgent surgical intervention to prevent severe complications such as anaphylaxis, bile leakage, and secondary infection.

METHODS

This retrospective study analyzed 13 patients with hydatid cyst perforation who were treated in a general surgery clinic between 2017 and 2022. Data regarding clinical presentation, diagnostic methods, surgical approaches, postoperative outcomes, and follow-up were reviewed. All patients underwent emergency surgery involving cyst evacuation, peritoneal lavage with scolicidal agents, and postoperative albendazole therapy.

RESULTS

The cohort included eight male and five female patients, with a mean age of 33 years. Spontaneous perforation occurred in 12 cases, and one case was due to trauma. The liver was the most commonly affected organ (92.3%). Surgical interventions consisted of partial cystectomy with omentopexy in 12 patients. The recurrence rate was 8%. Postoperative complications were minimal, including two bile fistulas that resolved spontaneously and one case of wound infection. The average hospital stay was 9.2 days, and the mean follow-up duration was 18.8 months. One patient with cirrhosis died due to complications from portal hypertension.

CONCLUSION

Hydatid cyst rupture is a rare but potentially life-threatening condition, particularly in endemic regions. Prompt surgical intervention, combined with postoperative albendazole therapy, is essential to reduce morbidity, mortality, and recurrence. Lifelong monitoring is recommended for patients with intraperitoneal perforations to manage potential complications of hydatidosis.