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April 29, 2026Clinical Case Reports0 citationsOpen Access

When Silence Speaks: A Perforated Hepatic Cyst, Intact Omental Cyst, and Cholelithiasis

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MHMohadese HematianPTPooneh TorabiMSMahsa Sayyari

Key Points

  • This case investigates the challenges of diagnosing multiple abdominal pathologies in an endemic region.
  • Urgent laparotomy performed on a 39-year-old man presenting with acute abdominal pain.
  • Imaging revealed cystic masses and free peritoneal fluid.
  • Surgical exploration uncovered three concurrent pathologies.
  • Findings included a perforated hepatic hydatid cyst, an intact omental cyst, and cholelithiasis.
  • The exact source of symptoms remained uncertain, highlighting diagnostic complexities.
  • Coexisting surgical diseases were demonstrated in the context of echinococcosis.

Abstract

ABSTRACT A 39‐year‐old man from an echinococcosis‐endemic region presented with acute left upper quadrant pain. Imaging revealed cholelithiasis, a hepatic and a large abdominal cystic masses, and significant free peritoneal fluid. Urgent laparotomy unexpectedly disclosed three concurrent pathologies: chronic calculous cholecystitis, a perforated hepatic hydatid cyst, and an intact omental hydatid cyst. The exact source of his symptoms remains uncertain. This case highlighted the diagnostic challenge of coexisting surgical diseases in endemic regions.

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Cite This Study

Hematian et al. (2026) studied this question.

synapsesocial.com/papers/69f154e0879cb923c4945384https://doi.org/10.1002/ccr3.72557
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