The management of abdominal hydatidosis after the rupture of a pancreatic hydatid cyst: a case report

INTRODUCTION Echinococcosis or hydatidosis is a zoonosis caused by cestodes from the genus Echinococcus; its habitat is the small intestine of the definitive host, represented by dogs/carnivorous animals, where it produces eggs which are eliminated in the environment. Cystic echinococcosis represents more than 95% of the hydatidosis cases registered annually. The most frequent localization is the hepatic one, followed by the pulmonary localization with a ratio of 2.5:1. A pancreatic localization represents 0.2% of hydatidosis cases with a higher possibility of disseminating intra-abdominally. The incidence of hydatidosis in Romania has not been investigated yet through national studies. CASE PRESENTATION We present the case of a 54-year-old Caucasian man who underwent emergency surgery in 1989 for symptoms suggestive for an acute abdomen. He was diagnosed intraoperatively with rupture of a pancreatic hydatid cyst, having a caudal localization and complicated by necrotic acute pancreatitis. Our objective is to describe a patient with hydatidosis, with unfavorable evolution after two surgical interventions, with intra-abdominal dissemination, for whom we considered the best therapeutic choice to be long-term anti-parasite drugs. CONCLUSIONS He has been treated with albendazole for 6 years and he shows a very good tolerance; praziquantel (600 mg/week) was also administered and he is under clinical and biological screening. There is no general consensus on the duration of anti-parasite treatments.