Traumatic rupture of hydatid cysts: A 12-year experience from an endemic region

Background: Trauma as a cause of hydatid cyst rupture leads to various clin ical sequelae, However, extensive data in the current literature regarding clinical presentation and management of such patients are racking. Methods: This article is a retrospective review of 16 patients with traumat ic rupture of hydatid cysts treated at a university hospital in an endemic area. Results: Falls (44%) were the most common cause of trauma. The ruptured cys ts were located in the liver in 13 patients (81%), in the spleen in 2 patie nts, and in the lung in 1 patient. Computerized tomography had a sensitivit y of 100% in demonstrating cyst rupture; whereas, ultrasonography had a sen sitivity of 85%. Ten patients (62%) had rupture into the peritoneal cavity and 5 patients (31%) into the biliary tree. Five (31%) of the cysts were in fected. Surgical procedures included introflexion (five patients), pericyst ectomy-choledochoduodenostomy (three patients), external drainage-choledoch oduodenostomy (two patients), unroofing-external drainage (two patients), s plenectomy (two patients), unroofing (one patient), and right hepatectomy ( one patient). Mean length of hospitalization was 15.9 days (range, 5-61 day s). One patient (6%) died, and eight patients (50%) developed complications . Nine patients (56%) were followed-up for an overage of 30 months (range, 3-72 months), and there was no recurrence. Conclusion: Computed tomography is currently the most sensitive diagnostic tool for demonstrating hydatid cyst rupture. The surgical options vary depe nding on intraoperative findings, Allergic reactions and recurrence as a re sult of intraperitoneal spillage are not as common as once believed, Biliar y rupture is associated with an increased rate of wound infection.