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INTRODUCTION AND IMPORTANCE: Hydatid cysts, caused by Echinococcus granulosus, are a significant public health problem in regions such as Tunisia and Morocco. These cysts primarily affect the liver and lungs but can also involve the spleen, kidneys, bones, and brain. Peritoneal hydatidosis, involving the formation of hydatid cysts in the peritoneal cavity, is a rare manifestation of this disease. This case report aims to highlight the presentation, diagnostic process, and surgical management of a primary peritoneal hydatid cyst. CASE PRESENTATION: A 73-year-old asymptomatic woman with no significant medical history was found to have a hypoechoic mass with a calcified wall in the liver segment IV and multiple multiloculated cystic masses in the peritoneum on an incidental abdominal ultrasound. Further evaluation with a CT scan revealed a hydatid cyst in liver segments IV and V and additional cystic formations in the peritoneum. Surgical exploration via midline incision identified and treated cysts in the omentum, liver, spleen, and pouch of Douglas. A total pericystectomy and other relevant procedures were performed. The patient's postoperative course was uncomplicated, and she recovered well. DISCUSSION: Peritoneal hydatidosis is typically secondary to hepatic hydatid cysts, caused by the parasite Echinococcus granulosus. The diagnosis is made primarily through imaging techniques such as CT and ultrasonography, which help to delineate the cysts and their relationships with adjacent structures. Treatment involves both medical and surgical approaches, with surgery being the primary intervention to prevent complications and recurrence. Scolicidal solutions are essential during surgery to prevent the dissemination of scolices. CONCLUSIONS: Primary peritoneal hydatidosis is a rare condition that is usually secondary to liver involvement. It is diagnosed by imaging and treated primarily through surgical intervention. Accurate diagnosis and timely management are crucial to prevent complications and ensure a favourable outcome.
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IMPORTANCE AND BACKGROUND: Gastric lipomas are rare submucosal tumours that account for less than 1 % of all stomach tumours. Despite their benign nature, they can lead to significant clinical manifestations such as gastric outlet obstruction and massive gastrointestinal haemorrhage. CASE PRESENTATION: We report the case of a 50-year-old woman with no prior comorbidities, presenting with severe upper gastrointestinal bleeding. Diagnostic imaging and endoscopy identified a submucosal mass in the prepyloric area, later confirmed to be a gastric lipoma. The surgical intervention involved laparoscopic resection of the mass. DISCUSSION: This case underscores the importance of considering gastric lipomas in differential diagnoses of gastrointestinal bleeding. While often asymptomatic, their potential to cause acute complications necessitates awareness among clinicians. The management strategies range from observational approaches in asymptomatic cases to surgical excision in symptomatic cases. CONCLUSIONS: Gastric lipomas, though rare and often benign, can present with life-threatening complications. Accurate diagnosis using a combination of endoscopy and imaging, particularly CT scans, is critical for effective management. Surgical removal remains the definitive treatment for symptomatic lipomas, highlighting the need for a tailored approach based on the tumour's characteristics and location.