Spontaneous Hemorrhagic Hepatic Hydatid Cyst Rupture Followed by Migration of Peritoneal Daughter Cyst

Human echinococcosis is a zoonotic infection mainly caused by Echinococcus granulosus belonging to Taenidea family.
Hydatid disease mainly affects the liver accounting for 50-70% of cases followed by the lungs 20-30%, and less frequently other organs.
Radiological and serological findings generally establish the diagnosis.
Hydatid disease has various complications: cysts may rupture into the biliary system, peritoneum or pleura cavity, they may become superinfected by bacteria, and may show migration or herniation due to pressure difference between the anatomic cavities and in some patients by contribution of gravity.
Our case presents a 75yo female with no history of trauma or systemic disease, admitted to Carmel medical center with sudden and severe right abdominal pain. Imaging revealed hemorrhagic direct rupture of a liver hydatid cyst. A second CT 8 days later showed migration of peritoneal cyst from RUQ to LLQ, and 3 months after that a third scan demonstrated dissemination disease in the peritoneal cavity.