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

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.