Extensive pulmonary artery embolisation caused by cardiac hydatid cyst rupture

This case study is a rare example of cardiac hydatidosis in a high-income country, where a middle-aged man presented with a ruptured right ventricular cyst causing anaphylaxis, pulmonary emboli and dissemination of Echinococcus throughout the lung. He survived the cyst rupture and underwent cardiac surgery but had incomplete resection and experienced progressive cardiopulmonary hydatidosis despite antihelminthic therapy. As a result, he experienced an array of cardiopulmonary sequelae over his lifespan. This case report highlights rare clinical manifestations of hydatid disease and potential complications of its treatment.

Hydatid Cysts of the Liver Rupture into the Peritoneal Cavity: Fifteen Cases and Review of the Literature

BackgroundHydatid cyst is a parasitic infection caused mainly by E. Granulosus, which is generally considered benign. However, the hepatic Hydatid Cyst rupture in the abdominal cavity is a life-threatening incident that requires urgent and multidisciplinary management (emergency physician, radiologists, anesthetists, and surgeons). This study describes clinical and paraclinical liver hydatid cyst rupture in the peritoneal cavity and details the appropriate treatment.Materials and MethodsFifteen liver hydatid cyst cases ruptured into the abdominal cavity that underwent urgent surgery were collected over eight years. Results There were nine men and six women. Patients' age ranged from 14 to 59 years, with an age average of 38 years. Two patients were admitted with abdominal trauma, and acute abdominal pain was the common consultation's reason. Only one patient had an anaphylactic shock. Both abdominal ultrasound and CT scan showed discontinuous cyst wall and intraperitoneal fluid in 100% of cases. Intraoperatively, the intraperitoneal effusion was clear in thirteen cases and purulent in two. All patients underwent unroofing procedure associated with intra-operative peritoneal lavage and external drainage. The mean hospital stay was 6.11 days, and the mean follow-up was 19 months. No case of recurrence was reported among the patients.ConclusionRupture of a hydatid cyst in the abdominal cavity should be evoked in front of acute abdominal pain, especially in endemic areas, and in the presence of an allergic reaction or anaphylactic shock signs. Combined surgical and medical care starting in the emergency room is the only guarantee of a good outcome.

Intraperitoneal Rupture of a Giant Hydatid Cyst of Liver- Can Emergency Placement of Intraperitoneal Drain Improve Patient Optimisation!

Hydatid cyst remains a global health problem. Intraperitoneal hydatid cyst rupture is a life-threatening complication because it causes serious hemodynamic instability and allergic reactions. No clearly defined guidelines exist for dealing with ruptured cysts or intraperitoneal spillage, though emergency exploration remains the standard approach. We present here a case of a 35 -year- old woman who developed spontaneous rupture of a Giant hepatic hydatid cyst. However, patient could not be taken up for emergency surgery in view of very poor chest condition. She was managed by placement of an intra peritoneal drain and lavage with hypertonic saline. Subsequently, patient underwent two surgeries for definitive treatment of the giant hydatid cyst. At one year of follow- up, patient has no evidence of any recurrent disease. Intraperitoneal drain placement and lavage with hypertonic saline may be considered an option to contain peritoneal implantations while patient is being optimised for exploration.