HYDATIDEMESIS - A BIZARRE PRESENTATION OF ABDOMINAL HYDATIDOSIS

A 31 year old male presented with high grade fever and abdominal pain of 20 days duration. At the age of 9 he had been operated on for a sol itary retroperitoneal hydatid cyst and had been asymptomatic until the age of 21 when he sustained a blunt injury to the abdomen. An explora tory laparotomy for splenic rupture revealed multiple intra-abdominal hydatid cysts, which were removed. The patient remained well until the present episode. An ultrasound examination revealed multiple intra-ab dominal hydatid cysts. Seven days after admission, the patient develop ed hydatidemesis (hydatid cysts and membranes in the vomitus) and hyda tidenteria (passage of hydatid membranes in the stools), and his pain and fever subsided. A Gastrografin study and a computerized tomography (CT) scan revealed hydatid cysts communicating with the stomach and d uodenum. In view of his disseminated recurrent abdominal hydatidosis, he was treated with high dose, long-term albendazole along with regula r follow up. This is the first documented case of disseminated abdomin al hydatidosis presenting with a cystogastric fistula and hydatidemesi s.