A case of rupture of an echinococcal cyst of the liver into the pleural cavity

In this article we describe a rare clinical case of rupture of hepatic echinococcal cyst into the pleural cavity. Direct rupture of a hydatid cyst, resulting in a communication with the pleural cavity, is one of the rarest complications of this disease.

Material and method. A 59-year-old female patient sought help with complaints of heaviness, aching pain in the right hypochondrium and right half of the chest for six months. The patient underwent a comprehensive preoperative examination, including an ultrasound examination of the abdominal and pleural cavities, computed tomography and magnetic resonance imaging of the chest and abdominal cavity.

Description of a clinical case. Diagnostic studies revealed a large mass in the right lobe of the liver with evidence of communication with the right pleural cavity through a diaphragmatic defect. Its structure was heterogeneous; attention was drawn to the uneven ribbon-like accumulation of the contrast agent in the central part with decrease in density along the periphery.

The patient's serological tests for echinococcosis were negative, and cytological examination of the pleural contents revealed reactive exudate. The patient underwent surgery, and intraoperative confirmation of a ruptured echinococcal cyst and a cystobiliary fistula were also identified.

Conclusion. Echinococcosis remains a severe public health problem despite advances in modern medicine. The disease can present without obvious symptoms or specific manifestations, highlighting the importance of diagnostic methods for accurate diagnosis.

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