Disseminated hydatid cysts as incidental finding in an unconscious female with abdominal distention, King Saud Medical City, Al-Riyadh, Saudi Arabia

Abstract

Hydatid disease, which is a parasitic infection caused by Echinococcus granuloses, primarily affects the liver and lungs, and there is a rare primary peritoneal involvement (2%). The diagnosis requires imaging (ultrasonography, computed tomography, and magnetic resonance imaging) and serology. Its management encompasses surgery and antiparasitic therapies. Our case underscores the diagnostic challenges, complications, and the importance of early detection and optimal treatment. A 25-year-old Ethiopian female presented with abdominal pains, distensions, and shortness of breath and was diagnosed with disseminated hydatid diseases with portal vein thrombosis. Imaging revealed extensive peritoneal cysts, hepatic involvement, and bronchopleural–peritoneal fistula. She was transferred to King Saud Medical City, where she received antiparasitic medications, anticoagulants, and blood transfusions before undergoing exploratory laparotomy, hydatid cyst excisions, and bladder repair due to intraoperative injury. Postoperatively, she was mechanically ventilated in the intensive care unit, hemodynamically stable, and received multidisciplinary care, including infectious disease, hepatobiliary surgery, and urology specialists. This case underscores the complexity in diagnosing and managing disseminated hydatid disease and thus emphasizes the significance of early detection, imaging, and multidisciplinary care. Surgical excision of the cyst remains essential, whereas antiparasitic therapy and anticoagulation support early recovery, thereby preventing recurrence and vascular complications in extensive peritoneal hydatidosis.