EN
TÜRKÇE
Poster - 11
SPONTANEOUS EXPULSION OF INTACT MEMBRANE OF LIVER HYDATID CYST : ABOUT TWO CASES
H Drissi*, A Ben Younes*, M Oumaya**, Y Ben Ahmed*, MS Jlidi**
*Hopital pour enfants Tunis
**Hopital pour enfants de tunis
PURPOSE
Rupture of hydatid cyst (HC) of the liver may be secondary to trauma or occur spontaneously.
We present two cases of spontaneous expulsion of intact germinative membrane, as a differential diagnosis of abdominal cystic masses that must be considered in endemic areas.
CASE 1
A 4 year-old girl presented abdominal pain, fever and a tenderness in the right upper quadrant. Abdominal US showed a 4cm cystic mass localized in under hepatic region with a digestive sturcture suggestive of a ruptured appendix. It also showed a 5cm heterogenic irregular lesion in the right lobe of the liver. The exact origin of this giant cyst could not be determined preoperatively.
At laparoscopy a turbid fluid and 5 cm cystic mass were observed under the liver. Parenchymal cavity in the right lobe of the liver was suggestive of an expulsed hydatid cyst. Laparotomy was performed, the intact germinative membrane was removed. Peritoneal cavity was irrigated with hypertonic saline solution. Albendazol and antibiotics were given.
CASE 2
A 9-year-old girl presented with fever and abdominal pain and a marked tenderness in the right iliac fossa. An ultrasound concluded an appendiceal abscess. An appendectomy via the McBurney incision was performed. Intraoperatively, we found an inflammatory appendix, as well as a cystic mass with an intact membrane in the hypogastrium. Appendicectomy was performed. The cystic mass was removed intact. Exploration of the liver revealed a parenchymal cavity in the left lobe, which was drained. Peritoneal lavage with hypertonic saline solution was performed. Albendazol and antibiotics were prescribed.
CONCLUSION
Expulsion of an intact germinative membrane is an extremely rare entity in cases of hydatid cyst of the liver. The intact free cyst should not be punctured or ruptured to avoid dissemination of cystic contents. Antiparasitic treatment should be given to prevent recurrence of the disease.