Background
The asymptomatic clinical presentation of hydatid cysts is the usual picture of presentations, and the cysts are incidentally discovered during radiological examination for other reasons. However, some patients develop symptoms and complications depending on cyst size, location, and the relationships between the cysts and the neighboring structures. Most dangerous complications consist of perforation of the cysts into the adjacent structures like a biliary tree, major vessels, hollow viscera, and peritoneal cavity. Herein, we aimed in this case report to describe the laparoscopic assessment and treatment of a case with an unusual presentation of intraperitoneal rupture of hepatic hydatid cyst after weight loss (post-sleeve gastrectomy) accompanied with review article.
Case summary
A female patient aged 44 was presented to our hospital with abdominal pain, diarrhea, and hypotension. The perforated cyst was located in the liver. Cyst rupture developed spontaneously. Enzyme-linked immunosorbent assay IgG result was negative. The patient received urgent resuscitation immediately and albendazole treatment was started 2 days before laparoscopic surgical intervention. No recurrence during postoperative follow-up (4 months).
Conclusion
Intraperitoneal perforation is a rare and severe life-threatening complication of hydatid cysts that can happen after significant weight loss. It is very crucial to treat the patients with appropriate emergent surgical management (including laparoscopy) as rapidly as possible after judicious medical treatment for allergic reactions.