Hydatid Cyst: Enteric Fistula in a Patient with Disseminated Abdominal Hydatidosis

Full Article

R Das, S Chakraborty, M Karmakar, N Panda

Hong Kong J Radiol 2015;18:297-301

DOI: 10.12809/hkjr1515325

Disseminated peritoneal hydatidosis is rare. Infrequently hydatid cysts can rupture into adjacent organs. We report a case of secondarily disseminated peritoneal hydatidosis with rupture into the gut presenting as hydatidorrhoea. A 26-year-old man presented with passage of white ‘grape’–like structures with stool. Ultrasonography showed disseminated hydatidosis. Magnetic resonance imaging further showed a large hydatid cyst arising from the parietal wall with a peripheral daughter cyst and localised air-fluid level, suggestive of a peritoneal hydatid cyst with enteric fistula. The fistulous site was demonstrated on magnetic resonance imaging. Due to the presence of disseminated disease, the patient was treated medically. Gastrointestinal complications of hydatid infestation are uncommon as the walls of the digestive tract offer major resistance to the formation of communication between the cystic cavity and the gastrointestinal lumen. Rare cases of rupture of hepatic hydatids into the stomach, duodenum, and colon have been reported. Peritoneal cyst rupture into the bowel is extremely rare. It is important to identify this uncommon complication and follow-up the patient for a prolonged period to ensure resolution of disseminated disease.

 

中文摘要

 

彌散性腹包蟲囊病引致的腸瘺

R Das, S Chakraborty, M Karmakar, N Panda

 

瀰漫性腹腔包蟲病很罕見。包蟲囊腫很少可破裂至鄰近器官。本文報告一例繼發性瀰漫性腹腔包蟲病破裂進入腸道的病例。患者為一名26歲男性,大便見白色葡萄狀的排泄物。超聲檢查顯示為瀰漫性包蟲病。磁共振成像進一步證實腔壁有一個大型包蟲囊腫,在其外圍另有一個小型囊腫,內有水–空氣界線,顯示腹膜包蟲囊腫引致的腸瘺。磁共振成像確定了腸瘺位置。此病例屬於彌散性,患者後接受藥物治療。由於消化道壁可以作為囊腔和胃腸管腔之間的一道屏障,因此包蟲能侵染胃腸道的機會很低。肝包蟲囊腫破裂而進入胃、十二指腸和結腸的情況很罕見,而腹腔囊腫破裂並進入腸道更為極其罕有。識別這種罕見的併發症並長期跟進患者以確保其完全消散至為關鍵。