Peritoneal hydatidosis secondary to an asymptomatic liver hydatid cyst rupture: A case report

Introduction and importance: Hydatid cysts, caused by Echinococcus granulosus, are a significant public health problem in regions such as Tunisia and Morocco. These cysts primarily affect the liver and lungs but can also involve the spleen, kidneys, bones, and brain. Peritoneal hydatidosis, involving the formation of hydatid cysts in the peritoneal cavity, is a rare manifestation of this disease. This case report aims to highlight the presentation, diagnostic process, and surgical management of a primary peritoneal hydatid cyst. Case presentation: A 73-year-old asymptomatic woman with no significant medical history was found to have a hypoechoic mass with a calcified wall in the liver segment IV and multiple multiloculated cystic masses in the peritoneum on an incidental abdominal ultrasound. Further evaluation with a CT scan revealed a hydatid cyst in liver segments IV and V and additional cystic formations in the peritoneum. Surgical exploration via midline incision identified and treated cysts in the omentum, liver, spleen, and pouch of Douglas. A total pericystectomy and other relevant procedures were performed. The patient's postoperative course was uncomplicated, and she recovered well. Discussion: Peritoneal hydatidosis is typically secondary to hepatic hydatid cysts, caused by the parasite Echinococcus granulosus. The diagnosis is made primarily through imaging techniques such as CT and ultrasonography, which help to delineate the cysts and their relationships with adjacent structures. Treatment involves both medical and surgical approaches, with surgery being the primary intervention to prevent complications and recurrence. Scolicidal solutions are essential during surgery to prevent the dissemination of scolices. Conclusions: Primary peritoneal hydatidosis is a rare condition that is usually secondary to liver involvement. It is diagnosed by imaging and treated primarily through surgical intervention. Accurate diagnosis and timely management are crucial to prevent complications and ensure a favourable outcome.