Primary retroperitoneal hydatid cyst with intraperitoneal rupture: a case report

Abstract

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.

Primary Retroperitoneal Echinococcal Cyst Treated With a Total Cystectomy

“…The total removal of the cyst is called a pericystectomy, or more accurately, a cystectomy, and is described as closed when the cyst is removed without opening it, and open when protoscolicides are used to kill the metacestodes before the cyst's content is evacuated, and the pericystic tissue is completely removed [ 2 ]. When a total cystectomy is not considered a viable treatment option due to adhesions to adjacent organs, then a partial cystectomy should be implemented [ 11 ]. It is vital during the procedure to prevent spillage of the cyst's content and to protect the peritoneal cavity through the application of pieces of gauze soaked in 20% hypertonic saline solution [ 15 ].…”

“…The first primary retroperitoneal echinococcal cyst was reported in 1958 [10]. Since then, a few similar cases have been reported in the existing literature [7,[11][12][13][14]. In a retrospective study of 121 cases of retroperitoneal echinococcosis, 68 patients were treated surgically.…”

Retroperitoneal hydatid cyst challenging the diagnosis: Case report with review of literature

“…The gold standard treatment for hydatid cysts is total cystectomy without contamination [ 14 ]. In some cases, when total cystectomy is not possible, partial cystectomy is the best option [ 15 ]. The main precaution to be taken while treating/excising the hydatid cyst from any location is the prevention of perforation and spillage of the content of the cyst [ 15 , 16 ].…”

“…With timely diagnosis and treatment, patients of hydatid cyst can enjoy a normal life, however, a late diagnosis due to a diagnostic dilemma or any other reason may result in complications like rupture of the cyst into the abdominal cavity [ 15 , 19 ].…”

Solitary retroperitoneal hydatid cyst masquerading as pseudocyst of pancreas

“…The CECT did not reveal classical septations and hyperechogenic matter in the cyst typical of a hydatid cyst. 5,6 Therefore, there was no clinical suspicion on arriving at differential diagnosis of hydatid cyst preoperatively. The diagnosis of hydatid cyst was finally established during the course of exploratory laparotomy.…”