Secondary disseminated intraperitoneal hydatid cyst: A case report

Hydatidosis is an uncommon zoonotic infection in the Philippines with only a few reported cases. It frequently presents as benign liver cysts with variable symptoms often related to mass effect. We present a 49-year-old male with a significant travel history from East and Central Asia, surgically treated twice as a benign liver cyst and now presenting with recurrent multiple intraabdominal cysts. He subsequently underwent surgical excision of multiple hydatid cysts with prolonged albendazole treatment. The patient presently remains disease-free as of most recent follow-up. The disease is caused by the tapeworm Echinococcus granulosus and transmission happens when humans acting as intermediate host ingest food contaminated with the parasite eggs, resulting to the liver being the most common location. Frequently, it manifests and is treated as incidental hepatic cysts for the disease is characterized to have a long asymptomatic period. Symptoms are variable and may range from having abdominal pain, increasing abdominal girth, vomiting, fever or myalgia. Ultrasound or CT scan reveals single or multiple cysts however, biopsy of the cyst wall with demonstration of the larval form (protoscoleces) is diagnostic. This case highlights the value of history-taking and having a high-index of suspicion particularly for rare cases. •Hydatidosis is a rare disease in South East Asia, particularly the Philippines.•A high-index of suspicion with significant travel or exposure in prevalent areas is often required to arrive at the diagnosis of Echinococcosis.•Cystic echinococcosis often presents as benign liver cysts with variable symptoms often related to mass effect.•Antihelminthics remains to be the treatment of choice with overall excellent prognosis.