Anaphylactic Shock Caused by Nonruptured Hydatid Cyst of the Liver

Abstract

Anaphylactic reaction is a known complication of cystic hydatid disease, a parasitic infestation caused by the larval/cyst stage of Echinococcus granulosus that usually happens after trauma or during interventions. Nontraumatic leakage of cyst contents into the blood circulation is an uncommon triggering factor for anaphylaxis, which is rarely reported in available literatures. We describe anaphylaxis in a 47-year-old lady who was admitted for evacuation of hydatid cyst of the liver. Unfortunately, she developed signs and symptoms of anaphylaxis in the ward while waiting for her operation. However, the condition was controlled immediately, and she was taken to the operating theater for surgery. As she had not sustained any trauma in the ward and operative exploration did not reveal any macroscopic rupture, we assumed that her problem must have been caused by nontraumatic spillage of cyst material into circulation. Although the condition is not common, one should bear in mind the possibility of such diagnosis in all patients with Eccinococcous infection who develop shock especially in areas where this infestation is endemic.

Anaesthetic Management of Anaphylactic Shock Caused by Nonruptured Hydatid Cyst of the Liver

“…In a previous study, the authors claimed leakage of cystic fluid into the bloodstream due to high intracystic pressure and blunt dissection (3,12). In our case, we believe that the high intracystic pressure coupled with blunt dissection must have been the cause of leakage of cystic contents through this vein into the circulation with no apparent macroscopic rupture.…”

“…Hydatid cyst has a high intracystic pressure and contains antigenic fluid (12). In a previous study, the authors claimed leakage of cystic fluid into the bloodstream due to high intracystic pressure and blunt dissection (3,12).…”

“…So, the same aetiology may also be effective in our case. In reviewing the literature, a few anaphylactic reactions have been reported with no apparent macroscopic rupture of the hydatid cysts (1,12).…”

Clinical Profile of Patients With Severe Anaphylaxis Hospitalized in the Spanish Hospital System: 1997-2011

“…Severe or recurrent anaphylaxis due to Echinococcus can occur if fluid from a cyst is released into a host who has developed IgE from a previous leakage [32,33]. Anaphylaxis complicates 10% of all intraperitoneal ruptures of cysts [34] and is responsible for 20% of sudden deaths occurring in echinococcosis [32,33]. In our literature review, we were unable to find an explanation for the severity of anaphylaxis in these patients.…”

Spontaneous Rupture of a Hepatic Hydatid Cyst with Anaphylaxis: A Case Report

“…Although the diameter of the cyst cavity was approximately 20 cm, the patient did not have any complaints before the rupture and anaphylaxis. Anaphylaxis because of spontaneous rupture in the peritoneal cavity is a rare but mortal complication of hydatid disease (1)(2)(3)(4)(5)(6). Surgery is still the gold standard treatment modality.…”