Trichobezoars are foreign and indigestible materials in the gastrointestinal tract and are usually found in psychiatric females, who often deny eating their own hair, but also at situations of gastric dysmotility and prior gastric surgery. Although rare, gastric trichobezoar should not be forgotten as a differential diagnosis in females presenting with vague epigastric pain. Its treatment well in time will prevent complications.

Background Hydatid disease is endemic in Mediterranean countries and most commonly occurs in the liver followed by the lung. A primary localization in the retroperitoneum is extremely rare. Case presentation We report the case of a 29-year-old Tunisian patient presenting with progressive left flank pain and skin urticaria. On abdominal ultrasonography and computed tomography scan, a ruptured retroperitoneal hydatid cyst was diagnosed, which was confirmed by positive hydatid serology. The treatment consisted of resection of protruding dome. The evolution was favorable. No local recurrence was detected during postoperative follow-up. Conclusions Primary retroperitoneal hydatid cyst is extremely rare and has uncommon presentation, but we should learn the keys to its diagnosis. In endemic regions, high suspicion for this disease is justified regardless of localization.

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