With CT evaluation, more effective interventions can be performed and the incidence of recurrence decreased. the risk factors for cyst perforation were young age, cyst diameter of > 10 cm, and superficial localization [4]. Immediate medical treatment against allergic reactions should be initiated, and emergency surgery should be performed after diagnosing rupture of hydatid cysts. The goal of the surgical treatment is to prevent complications, to eliminate

local disease, and to minimize morbidity, Compound C in vivo mortality, and recurrence rates [7, 12]. All of the techniques applied during liver hydatidosis surgery have minor or major disadvantages and are associated with various postoperative complications. The choice of a radical versus a conservative approach is controversial [3, 18]. Surgical treatment of the primary cyst should be the aim if the general condition of the patient allows. Pericystectomy and hepatectomy are rarely applied in cases of complicated hydatid cysts, but conservative surgical methods such as external drainage, unroofing, and cavity filling are frequently high throughput screening assay used [19]. In the study of Gunay et al. [14], only patients who were fit and could tolerate a radical procedure underwent such surgical

procedures. Generally, conservative methods are favored in endemic areas, and radical surgery is preferred outside the endemic area. We performed conservative techniques in most cases. Laparoscopic methods and percutaneous drainage of the hydatid cysts has gained interest during the last decade [20, 21]. However, we could not find any reports on their use for ruptured cases. We believe that these techniques presently have no place in the management of ruptured hydatid cysts with peritoneal spillage. After intervention for a perforated cyst, the most important step is irrigating the peritoneal cavity with a sufficient amount of scolicidal agents and careful, patient removal of all cystic content. Numerous solutions, such as hypertonic saline solution (15–30%), formalin (2%), silver nitrate (0.5%),

povidone-iodine (10%), chlorhexidine (0.05%), and a combination of cetrimide (0.5%) and chlorhexidine (0.4%), have been used as scolicidal agents for the purpose of inactivation [22, 23]. we used hypertonic saline solution. Now we use only 3% concentrations. Derici et al. [1] reported Montelukast Sodium that hypertonic saline is not appropriate because it may damage the peritoneal surfaces and may cause hypernatremia, we have not encountered any significant complications with the use of this solution. Additionally, we believe that profuse peritoneal lavage with hypertonic sodium chloride is mandatory for preventing intra abdominal recurrence of hydatid disease. Surgical mortality rates are as much as 3% even after surgery for uncomplicated hydatid cysts [1, 3, 14, 15]. Morbidity has been reported to be 12% to 63% [1, 3]. Derici et al., reported four deaths (23.5%) in a series of 17 patients [1].