Blunt abdominal trauma with unexpected anaphylactic shock due to rupture of hepatic hydatid cysts

Emergency Medicine
Original Case Report
10.1102/1470-5206.2002.0002
2
17-20
Blunt abdominal trauma with unexpected anaphylactic shock due to rupture of hepatic hydatid cysts

Hydatid disease, caused by the cestode Echinococcus, is common in Mediterranean regions. Depending on its size, an intact cyst may be ‘silent’ or may compress adjacent organs, causing symptoms. The cystic stage of Echinococcus granulosus is commonly located in the liver, which frequently results in a long symptom-free period [1]. Rupture of a hydatid cyst commonly gives rise to allergic phenomena, including anaphylactic shock [2]. Anaphylactic reactions due to hydatid cyst perforation usually occur during needle aspiration or open cyst surgery, as previously reported [3]. However, spillage of cyst fluid with intra-peritoneal rupture due to trauma may trigger anaphylaxis, although case reports of this are very rare [4].We report the case of a 12-year-old female who was admitted to our Emergency Department with abdominal trauma and survived anaphylactic shock due to traumatic spillage of hepatic hydatid cyst fluid. The initial indication of the cysts was confirmed with a focused abdominal sonogram for trauma (FAST). Essential life support measures were taken in the Emergency Department using oxygen, hydration, adrenalin and steroids. The paediatric surgeons who operated on her removed the cysts and washed out the peritoneal cavity, and her clinical condition stabilized within 24 h. The patient was treated with Albendazole (Methyl-5’propylthio-2-benzimidazole carbamate) for 4 weeks, and she was still healthy 1 year after the accident.

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Editor-in-Chief

Frank Cross
Consultant Vascular and General Surgeon
The London Clinic, UK

Editors

Neil Barnes
Consultant Physician
Barts Health NHS Trust, London, UK
Ali Jawad
Professor of Rheumatology
Barts Health NHS Trust, London, UK

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