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A middle age lady presented with abdominal pain was diagnosed to have multiple peritoneal and hepatic hydatid cysts on CT scan. Retrospectively she was found to have suffered blunt abdominal trauma. Case presentationA forty five year old lady presented with chronic dull aching pain with gradually increasing lump in the epigastric and pelvic region since 3 years. A well defined, firm mass of about 20 × 20 centimeters was palpable in epigastrium extending more on right hypochondrium, probably arising from left lobe of liver. A similar mass was palpable in the hypogastrium while multiple small nodular masses palpable in the right iliac fossa and lumbar region. Detailed inquest revealed a 5 year old incidence of blunt abdominal trauma, while working in her farm. The ultrasonography and CT scan (See Figure 1) showed multiple thin walled cysts of varying size involving left lobe of liver, peritoneal cavity, omentum and mesentery. Cysts showing internal septae and peripheral tiny calcific foci were also seen extending into pelvis around uterus, adnexae and retro-uterine cervical region, markedly compressing distal descending colon, sigmoid colon and rectum. Ileal loops were compressed and displaced superiorly. Serology for hydatid cyst disease was positive with ELISA test.Two courses of 4 weeks of Albendazole (15 mg/kg/day) were given with the interval of 1 month. The follow up after 1 month did not show any decrease in the size of the cysts and decision of laparotomy was taken. Peritoneal cavity was crammed with cysts ranging from 1 to 12 centimeters (See Figure 2). Omentum was studded with cysts (See Figure 3) which was incised and cysts were picked up (See Figure 4). A superficial cyst found in the left lobe of liver was opened with small incision and the hydatid fluid and daughter cysts were drained. After the excision of germinal membrane the cavity was masupialized. Later, the pelvic cavity was exposed and cysts adherent to adnexa, uterus, broad ligament, urinary bladder and rectum were removed. More than 250 cysts of different sizes were removed from the abdomen (See Figure 5). Patient died of anaphylactic shock within few hours of operation. DiscussionHydatid cyst disease is a zoonotic disease caused by the larval stage of Echinococcus granulosus (dog tapeworm),