Primary peritoneal hydatidosis

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Hydatid disease is a parasitic infestation caused by the tapeworm Echinococcus granulosus. Echinococcosis occurs worldwide and can affect multiple organs. The liver (75%) and the lungs (15%) are the most common sites of occurrence followed by the spleen, kidney, bones and brain. Peritoneal hydatidosis commonly occurs secondary to a ruptured hydatid cyst of the liver or the spleen. Primary peritoneal hydatidosis is an extremely rare entity accounting for just 2% of all intra-abdominal hydatid disease. Most patients remain asymptomatic for years before presenting with vague abdominal symptoms such as non-specific pain, abdominal fullness, dyspepsia, anorexia and vomiting. We successfully treated a 55-year-old woman with primary peritoneal hydatidosis. The role of imaging and immunological tests in the diagnosis is highlighted. The patient was managed by a combination of preoperative and postoperative antihelminthic therapy along with laparotomy, cyst deroofing, toileting and omentoplasty. The patient is asymptomatic at 1-year follow-up.

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