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Hydatid hepatic cysts rupture into the biliary tract, the peritoneal cavity, the thoracic cavity and the hepatic subcapsular space: specific computed tomography findings

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Abstract

Background:

This study attempts to demonstrate the role of computed tomography in the diagnosis of hepatic hydatid cyst rupture based on specific imaging findings and to propose combinations of the imaging findings diagnostic for specific types of rupture.

Methods:

Eleven patients were studied with computed tomography of the abdomen, with 4–8 mm slice thickness, after the oral administration of contrast material and intravenous contrast material in 6 cases.

Results:

Based on a combination of imaging findings the types of hepatic hydatid cyst rupture were: intrabiliary rupture in 7 patients, intraperitoneal rupture in 1 patient, intrathoracic rupture in 1 patient, hepatic subcapsular rupture in 2 patients. Structural deformity of the cyst was present in all cases, combined with: dilatation of the intrahepatic bile ducts (intrabiliary rupture); intraperitoneal fluid collections with diffuse haziness and stranding of the mesenteric fat (intraperitoneal rupture); an inhomogeneous lesion in the thorax with ipsilateral pleural effusion (intrathoracic rupture); a hydatid cyst located peripherally, with discontinuity of its adjacent to the hepatic capsule wall and subcapsular fluid collection (subcapsular rupture). The imaging findings were surgically and pathologically confirmed.

Conclusions:

Using combinations of specific imaging findings we correctly diagnosed the type of hepatic hydatid cyst rupture in all cases.

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References

  1. Ammann RW, Eckert J (1996) Parasitic diseases of the liver and intestines. Gastroenterol Clin 25(3):656–683

    Google Scholar 

  2. Tountas KI (1977) Concise textbook of surgery. Athens: Parisianos Medical Publications, pp 775–776

    Google Scholar 

  3. Eckert J Deplazes P (2004) Biological, epidemiological and clinical aspects of echinococcossis, a zoonosis of increasing concern. Clin Microbiol Rev 17(1):107–135

    Article  Google Scholar 

  4. Case 29 (1999), New Eng J Med 341(13):974–982

    Google Scholar 

  5. Karmali S, Thompson SK, McKinnon G, Anderson IB. (2005) A 37-year-old woman with fever and abdominal pain. CMAJ 172(13). doi:10.1503/cmaj.045058

  6. Kumar R, Reddy SN, Thulkar S (2002) Intrabiliary rupture of hydatid cyst: diagnosis with MRI and hepatobiliary isotope study. BJR 75:271–274

    PubMed  CAS  Google Scholar 

  7. Paksoy M, Karahasanoglou T, Carkman S, et al. (1998) Rupture of the hydatid disease of the liver into the biliary tracts. Dig Surg 15(1):25–29

    Article  PubMed  CAS  Google Scholar 

  8. Emre A, Ariogul O, Alper A, et al. (1990) Hydatid cysts of liver and portal hypertension. HPB Surg 2(2):129–133

    Article  PubMed  CAS  Google Scholar 

  9. Valle M, Serafini D, Bernardini P (1992) Complications of hepatic hydatidosis. Minerva Chir 47(15–16):1265–1274

    PubMed  CAS  Google Scholar 

  10. Androulakis GA (1986) Surgical management of complicated hydatid cysts of the liver. Eur Surg Res 18:145–150

    PubMed  CAS  Google Scholar 

  11. Erguney S, Tortum O, Taspinar AH, Ertem M, Gazioglu E (1991) Complicated hydatid cysts of the liver. Ann Chir 45:584–589

    PubMed  CAS  Google Scholar 

  12. Nutman TB, Weller PF (1998) Cestodes. In: Fauci AS, Braunwald E, Isselbacher KJ, et al. (eds) Harrison’s principles of internal medicine, 14th edn. New York: McGraw Hill, p 1225

    Google Scholar 

  13. Lewall DB, McCorkell SJ (1986) Rupture of echinococcal cysts: diagnosis, classification and clinical complications. AJR 146:391–394

    PubMed  CAS  Google Scholar 

  14. Sotirakis S, Himonas C, Korkoliakou P (2003) Hydatidosis-echinococcosis in Greece. Acta Trop 85:197–201

    Article  Google Scholar 

  15. Pedrosa I, Saiz A, Arrazola J, Ferreiros J, Pedrosa CS (2000) Hydatid disease: radiologic and pathologic features and complications. Radiographics 20:795–817

    PubMed  CAS  Google Scholar 

  16. Scherer V, Weinzierl M, Sturm R, et al. (1978) Computed tomography in hydatid disease of the liver: a report on 13 cases. J Comp Assist Tomogr 2:612–617

    Article  CAS  Google Scholar 

  17. Beggs I (1985) The radiology of hydatid disease. AJR 145:639–648

    PubMed  CAS  Google Scholar 

  18. von Sinner WN (1991) New diagnostic signs in hydatid disease; radiography, ultrasound, CT and MRI correlated to pathology. Eur J Radiol 12:150–159

    Article  Google Scholar 

  19. Borros JL (1978) Hydatid disease of the liver. Am J Surg 135:597–600

    Article  Google Scholar 

  20. Kornaros SE, Aboul-Nour TA (1996) Frank intrabiliary rupture of hydatid hepatic cyst: diagnosis and treatment. J Am Coll Surg 183:466–470

    PubMed  CAS  Google Scholar 

  21. Marti-Bonmati L, Menor F, Ballesta A (1988) Hydatid cyst of the liver: rupture into the biliary tree. AJR 150:1051–1053

    PubMed  CAS  Google Scholar 

  22. Kammerer WS, Schantz PM (1993) Echinococcal disease. Inf Dis Clin North Am (3):605–618

  23. Montero JVM, Gracia JA, Lafuente JL, et al. (1996) Fat-fluid level in hepatic hydatid cyst: a new sign of rupture into the biliary tree? AJR 167:91–94

    Google Scholar 

  24. Marti-Bonmati L, Menor SF (1990) Complications of hepatic hydatid cysts: ultrasound, computed tomography and magnetic resonance diagnosis. Gastrointest Radiol 15:119–125

    Article  PubMed  CAS  Google Scholar 

  25. Schipper HG, Lameris JS, van Delden OM, Rauws EA, Kager PA (2002) Percutaneous evacuation (PEVAC) of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material: first results of a modified PAIR method. Gut 50(5):718–723

    Article  PubMed  CAS  Google Scholar 

  26. Khuroo MS, Wani NA, Javid G, et al. (1997) Percutaneous drainage compared with surgery for hepatic hydatid cysts. New Eng J Med 337:881–887

    Article  PubMed  CAS  Google Scholar 

  27. Derici H, Tansug T, Reyhan E, Bozdag AD, Nazli O (2006) Acute intraperitoneal rupture of hydatid cysts. World J Surg 30(10):1879–1885

    Article  PubMed  Google Scholar 

  28. Beyrouti MI, Beyrouti R, Abbes I, et al. (2004) Acute rupture of hydatid cysts in the peritoneum: 17 cases. Presse Med 33(6):378–384

    Article  PubMed  Google Scholar 

  29. Suleyman M, Hekimoglu B, Yucesoy C, Serdar Arda I, Baran I (1999) Percutaneous treatment of hepatic hydatid cysts: an alternative to surgery. AJR 172:83–89

    Google Scholar 

  30. Kantarci M, Onbas O, Alper F, Celebi Y, Yigiter M, Okur A (2003) Anaphylaxis due to a rupture of hydatid cyst: Imaging findings of a ten-year-old boy. Emerg Radiol 10:49–50

    PubMed  Google Scholar 

  31. Di Cataldo A, Lanteri R, Caniglia S, Santangelo M, Occhipinti R, Li Destri G (2005) A rare complication of the hepatic hydatid cyst: intraperitoneal perforation without anaphylaxis. Int Surg 90(1):42–44

    PubMed  Google Scholar 

  32. Gomez R, Moreno E, Loinaz C, et al. (1995) Diaphragmatic or transdiaphragmatic thoracic involvement in hepatic hydatid disease: surgical trends and classification. World J Surg 19:714–719

    Article  PubMed  CAS  Google Scholar 

  33. Gogas C, Voloudaki A, Papakonstantinou O, Prassopoulos P, Gourtsoyiannis N. Transdiaphragmatic intrathoracic rupture of a hepatic dome hydatid cyst. doi:10.1594/EURORAD/CASE.776

  34. Domjan JM, Tung KT, Johnson C (1997) Bare area abscess: imaging findings and potential communication with the mediastinum. Br J Radiol 70:754–757

    PubMed  CAS  Google Scholar 

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Antonopoulos, P., Tavernaraki, K., Charalampopoulos, G. et al. Hydatid hepatic cysts rupture into the biliary tract, the peritoneal cavity, the thoracic cavity and the hepatic subcapsular space: specific computed tomography findings. Abdom Imaging 33, 294–300 (2008). https://doi.org/10.1007/s00261-007-9260-y

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  • DOI: https://doi.org/10.1007/s00261-007-9260-y

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