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Erschienen in:
20.04.2018 | GI Image
Intraperitoneal Rupture of Hepatic Hydatid Cysts
Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 1/2019
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A 46-year-old man from pastoral area presented to the surgeon’s office complaining of abdominal pain and new onset of jaundice for 2 days. Clinical examinations revealed jaundice, abdominal tenderness without tension and rebound pain. Biochemistry test indicated TBIL, 156 umol/L; ALT, 107 U/L; and AST, 114 U/L. An emergency computed tomography (CT) scan demonstrated multiple cystic lesion in the liver/spleen/omentum majus (Fig. 1a/c), and without brain/pulmonary invasion. Combined with patient’s native place and medical history, a primary diagnosis of hepatic hydatid cysts rupture was made. After anti-infective and liver protect treatment for 2 weeks and the hepatic function improved, albendazole (15 mg/kg/day) was administered for 10 months. When secondary hospitalized, the CT scan revealed reduced abdominal multiple cystic lesion (Fig. 1b/d). A laparoscopic exploration detected multiple cyst locations in the liver/spleen/omentum majus, and left liver lobe, spleen, and omentum majus resection was successfully implemented (Fig. 2). The diagnosis of intraperitoneal rupture of hepatic hydatid cysts with implantation and metastasis was confirmed (Fig. 3). The patients were discharged uneventfully 25 days after operation. Albendazole (15 mg/kg/day) was administered and planned to continue for 1 year.
Fig. 1
The abdominal CT scan demonstrated multiple cystic lesion in the left liver lobe, spleen, and omentum majus (a, c). The abdominal CT scan demonstrated reduced abdominal multiple cystic lesion after 10 months albendazole (15 mg/kg/day) treatment (b, d)
Fig. 2
The left liver lobe cyst location (a). The omentum majus cyst location (b)
Fig. 3
The surgical specimen: spleen (upper left), left liver lobe (upper right), and omentum majus (below)
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