A RARE CASE OF PRIMARY PERITONEAL HYDATIDOSIS

Hydatid disease or echinococcosis is a zoonosis which is common world wide. Dog is the definitive host. There are three species that cause hydatid disease Echinococcus granulosus, Echinococcus multilocularis and Echinococcus ligartus, of these E. Granulosus is common. The parasite has usually dog -sheep cycle but man becomes an accidental intermediate host. Hydatid disease is due to larval stage of E. granulosus in human. The most commonly involved organs are liver and lungs. Primary involvement of peritoneum is very rare. It can occur secondary to rupture of hepatic hydatid cyst. Investigations of choice are USG and C T abdomen. Surgery is the primary mode of treatment. Intraoperative peritoneal irrigation with scolicidal agents such as hypertonic saline is useful to prevent recurrence. Postoperatively patient should be on Albendazole 400mg twice daily for 4 weeks. A 42 year aged female referred for abdominal pain and mass in left hypochondrium, was diagnosed to have splenic hydatid cyst,during laparotomy found to have hydatid cysts in spleen and pouch of douglas.She was managed with splenectomy and removal of cysts from the pouch of douglas. This case of primary peritoneal hydatidosis involving pouch of douglas is presented here for its rarity in occurrence.