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Tumor markers such as carbohydrate antigen 19-9 (CA19-9) are generally useful in ruling out malignancy of hepatic cysts. The patient was a 72-year-old man who had a ruptured liver cyst in the right liver, which had been noted since he was 67 years old at another hospital. The initial laboratory tests demonstrated elevated CA19-9 (193 784.3 U/mL). We made the diagnosis with a simple ruptured liver cyst from magnetic resonance imaging and cytological examination of ascites, and laparoscopic fenestration with drainage of the abdominal fluid was performed. Pathological diagnosis of the resected wall cyst was non-parasitic simple hepatic cyst with acute inflammation and hemorrhage. The patient's serum levels of CA19-9 were 164.0 U/mL on postoperative day 23. The follow-up abdominal computed tomography scan performed 2 months later did not any finding of tumor. [ABSTRACT FROM AUTHOR]

Objective: The study retrospectively analyzed the clinical characteristics and prognosis of 17 cases of pregnancy complicated by borderline ovarian tumors to provide help for clinical workers. Materials and Methods: The clinicopathological data of 17 patients with ovarian borderline tumors during pregnancy at the Shengjing Hospital of China Medical University from January 2015 to June 2021 were collected and analyzed retrospectively. The average age of the patients was 31.82 years (25-45 years), the average number of pregnancies was 2.06 times (1-6 times), and the average number of births was 0.41 times (0-1 time). Results: Among the 17 patients, 4 were diagnosed in the first trimester, 2 in the second trimester, and 11 in the third trimester. Most of the first symptoms were cysts, cyst enlargement, or cyst rupture. Among them, 3 cases (1 in the first trimester and 2 in the second trimester) continued pregnancy after a conservative operation, 9 cases underwent cesarean section and a conservative operation simultaneously, and the mother and child had a good outcome. Two cases underwent conservative operations and induced abortion, and 1 case underwent an ectopic pregnancy operation at the same time. The prognosis of the patients was good without recurrence. Conclusion: Preoperative diagnosis of borderline ovarian tumors in pregnancy is delayed, and imaging and tumor markers are not specific. The coincidence rate between intraoperative frozen pathology and postoperative paraffin pathology was not high. Borderline tumors are mainly treated by surgery, and the prognosis for mothers and infants is good. [ABSTRACT FROM AUTHOR]

Background: Hydatid cyst is a zoonotic disease caused by the parasite Echinococcus granulosus. The tapeworm larvae can create cyst in different areas of the body, especially the liver and lungs; however, the formation of the cyst in the perineal and femoral regions are very rare. The unusual location of the cyst can help us with the differential diagnosis of soft tissue mass(es) in this location, especially in endemic areas. Diagnosis of this disease is crucial because if the cysts are ruptured during surgery, the fluid inside can cause anaphylactic shock.Case Presentation: Our case is a 55-year-old woman with the chief complaint of a painful mass in the right thigh and perineal area with progressed pain and paresthesia to the right thigh and shin. The patient had no history of fever, abdominal pain, digestive dysfunctions, or chest pain. The vital signs were normal, and there was no family history. Physical examination showed that the skin over the mass had no discoloration, and the size was around 5.7 cm long. The result of the ultrasonography examination showed a cystic mass with suspicion toward the femoral hernia. After a CT scan, the result of secondary workups was a multi-lobular cystic mass with no connection to the abdominal region, which suggested a hydatid cyst. The patient underwent spinal anesthesia and surgery, a cystic mass with ecto- and endocyst, with clinical similarity to a hydatid cyst, was removed with wide margins, and the cyst wall was kept intact. In the next step, the specimen was sent for histological examination that confirmed cystic hydatidosis. The Post-surgical Abdominal and thoracic Ultrasonography screening were used to exclude relapse, and medical therapy was given for 3-6 months. An 18-months follow-up demonstrated no reoccurrence and no newly formed cyst.Conclusions: Although rare, femoral hydatid cyst can occur in some cases, especially in endemic areas. We highly recommend our colleagues consider ruling out cystic hydatidosis in any patients complaining of regional mass(es), mostly painless, presenting with adjacent tissue compression with or without manifestation of an allergic reaction. [ABSTRACT FROM AUTHOR]

Fine Needle Aspiration Cytology (FNAC) is a cost effective, minimally invasive technique which is used for diagnosing various non-neoplastic and neoplastic lesions. However, its use is restricted in ovarian cancer diagnosis due to various factors such as difficulty in sub-typing with cytology alone, fear of spillage of tumor cells to peritoneal cavity etc. In this study, we analysed 45 cases of ovarian masses and FNAC of these cases were performed Under Ultrasonography (USG) guidance. Histopathology diagnosis was compared with cytology in all these cases. For statistical analysis, 39 cases were considered. Cytological analysis detected 18 cases as malignant neoplasms and all of them were found to be malignant in histological analysis as well. In the present study, no incidence of cyst rupture or any other complication occurred during the procedure. FNAC is a safe and economic procedure with acceptable diagnostic accuracy especially in the experienced hands. False negative results of FNAC in ovarian cystic lesions were mainly due to the low cellularity of the sample and secondary degenerative changes. This can be avoided to certain extend by preparing cell blocks and hence we suggest the same. The distinction between cystadenocarcinoma and borderline tumours cannot be confidently made by cytology alone. All clinical and sonographic findings should be considered in collaboration with FNAC findings for arriving at a diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Arachnoid cysts are a common incidental finding on head imaging. While the natural history of these cysts in poorly described, hemorrhage with subdural hygroma formation is rare. We review the clinical course of a patient who developed a subdural hygroma following trauma. Case: The patient was a previously healthy 14-monthold male who presented to the Emergency Department with vomiting after a fall and was found to have esotropia without other focal neurological deficits and a CT scan consistent with a subdural cerebrospinal fluid collection with midline shift. The patient was treated conservatively and his symptoms resolved. Discussion: Arachnoid cyst rupture is a rare complication which can lead to increased intracranial pressure with devastating consequences. Clinical manifestation can be similar to that of other intracranial pathologies. Prompt diagnosis is required to avoid life-threatening symptoms. Conclusion: Arachnoid cyst rupture should be considered when evaluating patients with non-specific neurological symptoms following trauma. [ABSTRACT FROM AUTHOR]

Background: Presacral tumors are a group of rare and heterogeneous tumors that arise from the potential presacral space between the rectum and sacrum. The low occurrence and diverse origins make the diagnosis and treatment of these tumors a challenge. The aim of the study was to retrospectively review patient demographics and to identify advantages and disadvantages in the diagnosis and treatment of these tumors. Methods: Retrospectively collected and reviewed data from patients who received treatment of presacral tumors at the First Affiliated Hospital of China Medical University between August 2009 and June 2019. Results: The data from forty-four patients (33 females) with a median age of 50 years who were diagnosed with a presacral/retrorectal tumor were analyzed. The majority of tumors were congenital (61.4%) and benign tumors are more common (59.1%). The median age of patients with benign tumor was significantly higher than that of malignant tumor. The most common symptoms were sacrococcygeal/perianal pain (56.8%) and mass (36.4%), and 8 out of 9 patients having lower limb symptoms diagnosed with malignant tumor. The tumor detection rate of digital rectal examination was 75% and more than 90% of all patients underwent one or more radiology imaging exams for tumor diagnosis. Every patient had a biopsy result. The most common type of tumor was presacral cyst (40.9%) with overall tumor median size of 5.6 cm. Thirty-one (70.5%) patients underwent surgery, most often via the posterior route (83.9%). Posterior route surgery had significantly shorter operation time and tumors operated via posterior route were significantly smaller. The survival rate after surgery was 100%. The median course of disease was 6 months and median follow-up was 25 months. Conclusions: Presacral tumors have low occurrence and are more frequently observed in females in their 30s and 50s indicating a possible link between tumor occurrence and hormonal changes. Patients with lower limb symptoms were more likely to have a malignant presacral tumor. Posterior route was the most commonly utilized surgical approach. Supplementary iodine tincture treatment of cysts ruptured in operation could potentially be helpful in reducing the chance of recurrence. [ABSTRACT FROM AUTHOR]

Hydatid cyst is a common infestation caused by helminths in humans and usually involves the liver and lungs. Primarily, cases of hydatid cysts in the thigh muscles are extremely rare and are generally in the form of case reports. It is an important disease due to its insidious course, its confusion with other soft tissue pathologies, delay in diagnosis and painstaking surgery. In our study, the largest case series in the literature, the clinical stages of the diagnosis, treatment and follow-up of 9 hydatid cysts that develop primarily in the thigh muscles were evaluated. The risk of recurrence in primary hydatid cyst of the thigh can be reduced with rapid diagnosis, careful preoperative planning, complete surgical resection by avoiding cyst rupture and concomitant anthelmintic chemotherapy. [ABSTRACT FROM AUTHOR]

Hydatid cysts or Hydatid disease is caused by Echinococcus granulosus infestation. Dogs, wolves, and other carnivores are the definitive host, and human being the accidental intermediate hosts. This disease commonly involves the liver and lungs and rarely involves other organs of the body. Primary intramedullary hydatid cysts are extremely rare and few cases before us have been reported in the literature. There is no pathognomonic sign or symptom for spinal hydatid cyst, mostly compression related symptoms, e.g. radiculopathy, myelopathy, local pain, and pathologic fractures are found. So preoperative diagnosis of spinal hydatid requires the correlation of all the aspects including clinical features, radiology, and lab reports. Surgical management is the best treatment for spinal hydatid cyst with complete excision without cyst rupture being the primary target along with complete neural elements decompression. Here we report a case of a 26-year old male with paraparesis with MRI finding directing towards D9-D10 intramedullary cystic lesion (cystic astrocytoma) which was completely excised and histopathology report favored intramedullary hydatid cyst. [ABSTRACT FROM AUTHOR]

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Objective: To evaluate if follow-up cystography alters clinical management in patients after treatment of traumatic bladder ruptures.Methods: Patients with uncomplicated blunt trauma bladder ruptures between 2000 and 2014 were identified in our institutional trauma registry. Primary management strategies consisted of either cystorrhaphy or catheter drainage. Primary outcome analyzed was occurrence of positive follow-up cystogram. Secondary outcomes were use of follow-up cystography and time to negative cystogram.Results: One hundred forty patients were identified with a median follow-up of 6.2 months (interquartile range [IQR] 3.0-32.4). Eighty-two patients (58.6%) had extraperitoneal (EP) ruptures, 49 had intraperitoneal (IP) ruptures (35.0%), and 9 had combined EP/IP rupture (6.4%). Fifty-six EP patients were managed with catheter drainage, whereas all other patients underwent cystorrhaphy. Thirty-five cystorrhaphy patients (42%) had no imaging before catheter removal. Forty-nine patients (58%) had cystograms at a median of 15.0 days (IQR 10.0-22.0) after cystorrhaphy, with only 1 patient having a persistent leak. Forty-six catheter drainage EP patients (82%) had negative cystograms at a median of 19.0 days (IQR 15.0-33.0). Of the 10 patients with persistent extravasation, 7 required operations for related complications, whereas 3 had negative imaging at a median of 38.0 days (IQR 25.8-66.8), with a mean of 2.8 cystograms before a negative study.Conclusion: Follow-up cystography after cystorrhaphy for uncomplicated blunt trauma-associated bladder ruptures rarely, if ever, provides unanticipated clinical information. For catheter drainage EP patients, cystography remains clinically valuable, as at least 18% of patients will have signs of continued extravasation. The optimal timing of cystography and catheter removal remains unknown. [ABSTRACT FROM AUTHOR]

Background: Blake's pouch cyst forms from non-permeabilization of Blake's pouch. It is difficult to visualize at necropsy as the cyst ruptures easily into the 4th ventricle during dissection. Case report: Based upon prenatal imaging, delicate dissection allowed post-mortem confirmation of the Blake's pouch cyst. Conclusions: This highlights the importance of utilizing premortem imaging to help guide the postmortem dissection and documentation of a posterior fossa cyst. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 12-year-old female with a history of fever and rhinorrhea. Topics include prescribing amoxicillin without improvement and complaining of right chest pain showing no signs of respiratory distress; and revealing a lesion on the medium right lobe with regular contours, thin walls, and hypodense content, suggesting a probable congenital malformation.

Background: Hepatic cystadenoma is a rare benign cystic tumor; it tends to recur after incomplete surgical resection and has malignant potential. We report the case of a patient with a ruptured biliary cystadenoma in the common bile duct that caused diagnostic and therapeutic problems.Case Presentation: A 34-year-old North African woman, admitted for angiocholitis, was operated 2 months before for a hepatic cystic lesion taken for a hydatid cyst compressing her common bile duct. The clinical and the complementary examinations converged toward recurrence of the hydatid cyst for which a surgical resection was decided. Intraoperative findings as well as the histological study of the "membranes" extracted from her common bile duct indicated a hepatic cystadenoma.Conclusions: The rarity of hepatic cystadenoma and the non-specificity of clinical and imaging signs make diagnosis of hepatic cystadenoma difficult, especially when it is complicated by rupture in the bile ducts; this contributes to a delay in diagnosis and an inadequate therapeutic approach. [ABSTRACT FROM AUTHOR]

Synovial cysts of the lumbar zygapophysial joints can be treated by percutaneous injection of corticosteroids, with distension and rupture of the cyst. Some cysts can be difficult to access, particularly when they lie deep in relation to the lamina. This technical report describes a fluoroscopy-guided technique for accessing sublaminar pathology. Crucial to the safety of the technique is visualization of the ventral margin of the lamina using a contralateral oblique view, and controlling and limiting the insertion of the needle such that only its tip passes the lamina. [ABSTRACT FROM AUTHOR]

Progress in diagnosis, treatment and elimination of echinococcosis and cysticercosis. The diagnosis of the disease is most often accidental and accompanies an imaging examination of the abdominal cavity. In the process of qualifying for bariatric surgery, many examinations should be performed, including ultrasound of the abdominal cavity or gastroscopy in order to exclude lesions that may be a contraindication to the surgery. [Extracted from the article]

We describe an adult female presenting with dyspnea in whom both transthoracic and transesophageal echocardiography detected a mobile sac-like structure in the right ventricular outflow tract ( RVOT) containing a heterogenous echogenic mass. This sac-like structure markedly changed its shape and size during the cardiac cycle. These findings and the fact that the patient lived in a rural area raised the possibility that this was a hydatid cyst. A bubble study using normal saline was useful in detecting a contained rupture of the cyst. Bubble echoes were noted within the sac-like structure but did not penetrate the inner wall of the cyst which contained echogenic material, indicating that the rupture was confined only to the outer layers. At surgery, a 0.5 cm communication was noted between the cyst and the RVOT and pathology confirmed the diagnosis of hydatid cyst. [ABSTRACT FROM AUTHOR]

Background: Tumor markers are widely applied in clinical practice, however, few serum markers have been found for intracranial tumors. Herein, we firstly report an intracranial epidermoid cyst case with extremely high level of serum CA 199. Furthermore, the relationship between CA 199 level and intracranial epidermoid cyst was closely followed for a long period.Case Presentation: We report a case of 41-year-old man with a history of 2 months' headache and sudden exacerbation for 3 days. Radiology examination suggested multiple lesions spreading along ventricular system. Laboratory tests showed exceeding increase of serum CA 199. The patient underwent craniotomy and continuous lumber drainage. Post-operative pathology proved a ruptured intracranial epidermoid cyst. MRI scans and serum CA 199 were closely followed up for three years.Conclusion: This case suggests an important role of serum CA 199 in the diagnosis and follow-up of intracranial epidermoid cyst. Ruptured intracranial epidermoid cyst should be considered for a sudden onset case with multiple intracranial lesions and dramatically increased serum CA 199. [ABSTRACT FROM AUTHOR]

Background Hydatid disease is endemic in certain areas of the world and it is located mostly in the liver. Intraperitoneal rupture is rare. Rupture may result from trauma or may occur spontaneously from increased pressure of the cystic fluid. Ruptured hydatid cyst is a rare cause of ascites, but should be considered in the differential diagnosis, especially in endemic areas. The diagnosis of ruptured hydatid cyst should be prompt because it requires emergency intervention. Case presentation The present case refers to a 62 year old Tunisian male admitted in our institution for diffuse abdominal distension. Physical examination was unremarkable except for the presence of ascites. Abdominal ultrasonography showed a large amount of fluid into the peritoneal cavity associated with many intraperitoneal cysts with a scalloping on the liver. It showed also a heterogeneous cystic lesion of the segment II of the liver. Abdominal computed tomography (CT) revealed in addition a fat infiltration and a thickening of the peritoneum. Thus intraperitoneal hydatid cyst rupture was suspected and emergency laparotomy was performed. A yellow serous fluid , containing many daughter vesicles disseminated through the peritoneal cavity was noted. A mass consistent with a hydatid cyst was noted at segment II of the liver with a tear on the inferior surface. Thus, intraperitoneal rupture of hepatic hydatid cyst was diagnosed. Conclusion The rupture of hydatid cyst into the peritoneal cavity is rare but presents a challenge for the radiologist and the surgeon. This condition is included in the differential diagnosis of ascites in endemic areas. [ABSTRACT FROM AUTHOR]

With the availability of the highly sensitive β-human chorionic gonadotropin (β-hCG) assays, all pregnancies, including ectopic pregnancies (EP), are expected to have detectable serum β-hCG at 4 weeks' gestation or 9 days following blastocyst transfer. To our knowledge, this is the first report of a woman who underwent in vitro fertilization, had undetectable serum β-hCG 9 days after blastocyst transfer, and was then diagnosed with a ruptured abdominal EP and intra-abdominal bleeding 19 days later. This case highlights that the rise in serum β-hCG might be delayed in abdominal EP compared to intrauterine pregnancy. This delay should raise the suspicion for EP, thus meriting close monitoring. Moreover, in the absence of menstruation, an undetectable serum β-hCG 9 days post-blastocyst transfer should prompt β-hCG measurement in 2-3 days to avoid the misdiagnosis of an EP. [ABSTRACT FROM AUTHOR]

Odontogenic cysts are derived from odontogenic epithelium, can be locally invasive and destructive and have been reported rarely in cats. A 16-year-old, male domestic shorthair cat had a 3-year history of a slowly progressive, right mandibular swelling. Intraoral dental radiographs revealed a multilocular, radiolucent, cystic mass within the right mandible that extended from the distal aspect of the canine tooth to the mesial aspect of the fourth premolar tooth. Radiographically, the mass was associated with distortion and regional destruction of the right mandibular bone and resorption of regional tooth roots. Histological examination of an incisional biopsy sample revealed multiple ruptured cysts lined by stratified squamous epithelium of odontogenic origin with luminal parakeratinization and a prominent palisading basal cell layer. The cyst contained abundant orthokeratotic and parakeratotic keratin. The clinical, radiographical and histological features were consistent with a diagnosis of odontogenickeratocyst, as seen in man. This is the first report of an odontogenickeratocyst in a cat. [ABSTRACT FROM AUTHOR]

In a 33-year-old male patient, magnetic resonance imaging (MRI) demonstrated cranial multicentric epidermoid cyst and rupture of the cysts. Dermoid cysts are extremely rare inclusion cysts constituting less than 0.5 % of all primary intracranial tumors. Most of them are asymptomatic. Multicentric type of dermoid cysts have been reported very rarely in the literature. Most of these cysts are asymptomatic. Hormonal changes with age can increase the glandular secretions resulting in the rupture of rapidly enlarging cysts. Magnetic resonance imaging displays the typical findings of rupture. There has been only one case of multicentric dermoid cyst reported in the literature until now. [ABSTRACT FROM AUTHOR]

Hemorrhagic cholecystitis with subsequent gallbladder rupture and torrential bleeding is a very rare but life-threatening complication of acute biliary tract diseases. Its clinical presentation may be dubious and therefore Computed Tomography (CT) imaging plays a crucial role in a prompt and accurate diagnosis. We present a case of a 64 year-old male who was admitted to the emergency department with clinical findings of acute cholecystitis. During the following hours the patient became hemodynamically unstable and an emergency abdominal CT scan was performed. CT revealed massive hemoperitoneum containing free gallstones. In addition, active extravasation of iv contrast material inside the gallbladder lumen was demonstrated. Based on these findings hemorrhagic cholecystitis with gallbladder rupture was suspected and the patient underwent urgent laparotomy. We describe specific CT findings of this rare condition, thus emphasizing the role of imaging in facilitating urgent surgical treatment. [ABSTRACT FROM AUTHOR]

Abstract: Mesenteric cysts are rare abdominal tumors of unclear histologic origin, usually asymptomatic. Post-traumatic mesenteric cyst usually results as a consequence of a mesenteric lymphangitic rupture or a hematoma followed by absorption and cystic degeneration. The preoperative histological and radiological diagnosis is difficult. We present the case of a 45-year-old male patient with sizable, palpable abdominal tumor, the gradual swelling of which the patient himself combined with the blunt abdominal trauma he acquired from an opponent''s knee in a football game 5 months ago. [Copyright &y& Elsevier]

Purpose: Spontaneous perforation is a rare complication of choledochal cyst (CDC) which is difficult to diagnose due to its nonspecific clinical presentation. The surgical treatment can be either single-staged cyst excision or two-staged procedure with an initial drainage followed by delayed cyst excision. Both biliary duct obstruction and irritation due to refluxed pancreatic juice have been proposed as possible aetiology. In this report, we describe six cases of CDC perforation in hope to have a better understanding on the clinical features and cause of this complication.Methods: Medical records of six patients whose diagnoses of perforated CDC were confirmed with intra-operative findings were retrospectively reviewed. Clinical data, investigation results and post-operative outcomes were analysed.Results: Vomiting and abdominal pain were the most common complaints. Few patients present with clinical jaundice. Overt sign of peritonitis was absent. Both single-staged and two-staged approach offered satisfactory outcome.Conclusion: Hyperbilirubinaemia and remote free intra-peritoneal fluid allude the diagnosis of perforated CDC. When presenting with cholangitis, it warrants timely surgical intervention to prevent perforation. Single-staged or two-staged surgical approach would depend on stability of patient and surgical expertise available. Reversible dilatation of intra-hepatic duct suggests that increased intra-ductal pressure is a contributing factor to the perforation. [ABSTRACT FROM AUTHOR]

A 69-year-old female presented with abdominal pain for 3 days without trauma history. Ultrasound examination showed that she had a hepatic cystic lesion, which was enhanced on contrast computed tomography. Surgical intervention was performed 6 days after admission; bloody ascites in the peritoneal cavity, a ruptured cyst 12 cm in size, and a rupture hole over the cystic wall were noted. Spontaneous rupture is an infrequent presentation in a simple hepatic cyst with only a few case reports in the English and Japanese literature. Spontaneous rupture of a simple hepatic cyst with intracystic hemorrhage can pose a problem in differential diagnosis from cystic neoplasm of the liver and needs further management. [Copyright &y& Elsevier]

We present a case of a 50-year-old woman with acute dacryocystitis that was complicated by posterior rupture of the lacrimal sac causing an orbital cellulitis with subsequent visual acuity of no light perception. Upon presentation, she was immediately started on broad-spectrum antibiotics and underwent surgical incision and drainage of the lacrimal sac abscess but never regained vision. There are 4 cases in the literature of permanent severe vision loss from acute dacryocystitis. Prompt diagnosis and close monitoring of acute dacryocystitis are therefore essential to prevent extension into the orbit and possible optic nerve compromise. [ABSTRACT FROM AUTHOR]

Epithelial ovarian tumors are the most common malignant ovarian neoplasms and, in most cases, eventual rupture of such tumors is associated with a surgical procedure. The authors report the case of a 54-year-old woman who presented with spontaneous rupture of ovarian cystadenocarcinoma documented by computed tomography, both before and after the event. In such cases, a post rupture staging tends to be less favorable, compromising the prognosis. [ABSTRACT FROM AUTHOR]

The need for surgery in pancreatic pseudocysts in children is directly related to the status of the duct of Wirsung. Clinical deterioration was often the factor leading to surgery. The retrospective study of ten cases of pancreatic pseudocyst pointed to the value of ultrasound as an indicator of pancreatic duct involvement. CT was also of help in one case. ERCP, performed only in one patient before surgery, may be indicated in difficult cases. [ABSTRACT FROM AUTHOR]

We discussed the case of a 14-year-old patient with acute onset of psychiatric symptoms for two months who had been examined and different antipsychotic drugs had been prescribed by several psychiatrists without any neuroradiological imaging. Because of unresponsiveness to the antipsychotic drugs, computed tomography and magnetic resonance imaging were performed which revealed a ruptured intracranial dermoid cyst. The patient underwent surgery and antipsychotic medications were withdrawn in short time. The emphasis of this case is that intracranial lesions can present with neuropsychiatric symptoms and findings only without any neurological deficit or signs. [ABSTRACT FROM AUTHOR]

The article presents a case study of an 18-year-old male patient who experienced recurrent vomiting, dull aching pain, and heaviness in his upper abdomen. He underwent contrast-enhanced computed tomography (CECT) abdomen which showed large cyst of liver and spleen. The article discusses the intra-peritoneal rupture of a hydatid cyst, risk factors for spontaneous rupture, and resuscitated for anaphylactic shock and peritonitis.