Peritoneal hydatid cyst perforation: a rare cause of emergency abdominal surgeries

Introduction  In hydatid cyst disease, perforation and spontaneous fistula formation are rare, yet very serious, complications. In this study we describe five cases of hydatid cyst disease in which the cysts perforated. Methods  In this retrospective study we evaluated five patients who were surgically treated for perforated hydatid cysts between 2002 and 2006. All patients were admitted to a local hospital with acute abdominal symptoms. Results  The mean age of the patients (four males and one female) was 39 years. The perforations occurred spontaneously in four patients, and were the result of trauma in one. Three of the hydatid cysts were located in the liver and two in the spleen. Only one patient had a recurrent hydatid cyst. Diagnostic tools included ultrasonography (n=5), computerized tomography (n=1), and diagnostic peritoneal lavage (n=1). The cysts were treated by radical (n=2) or conservative (n=3) methods. There was no postoperative morbidity or mortality, and no recurrences of hydatid disease after follow-up (mean: 14 months). Conclusion  Cyst perforation in the peritoneal cavity is a serious complication of hydatid disease and should be treated immediately. The literature suggests that recurrences may be related to the operative technique, the location of the cyst, and inadequate irrigation of the peritoneal cavity with scolicidal agents. The findings of this study suggest that if treated promptly, cyst perforation can be successfully treated.