Spontaneous Rupture of a Hepatic Hydatid Cyst Perforating into the Gastric Antrum Diagnosed with Magnetic Resonance Imaging A Case Report and Review of the Literature

BACKGROUND: Hepatic hydatid disease is a parasitic zoonosis caused by Echinococcus granulosus. The liver is the most frequently parasitized organ in humans. E. granulosus typically forms a small, fibrous, edged cyst when there is any surrounding host reaction. Classically, there is a large parental cyst with a large number of peripheral daughter cysts. Satellite daughter cysts are common. E. granulosus has two forms: pastoral and sylvatic. CASE: A 36-year-old woman was hospitalized upon complaint of nonspecific, continuous, moderate-to-severe epigastric pain of 1 week's duration. There was no fever or vomiting. Only serum aspartate transaminase (420 U/L), alanine aminotransferase (180 U/L) (normal up to 50 U/L), and erythrocyte sedimentation rate (65 mm/hour) were increased in her laboratory findings. She had a hydatid cyst in the right lobe of the liver and refused all treatment protocols. Her magnetic resonance imaging and magnetic resonance cholangiopancreatography data showed a ruptured liver hydatid cyst associated with closed perforation in the antrum region of the stomach. CONCLUSION: Typically, locations of hepatic hydatid cyst can be seen into the biliary tree, peritoneal space, and blood stream, but extension outside of the liver is rarely seen in the literature.