We present a patient with slow rupture of hydatid cyst into the peritoneal cavity, presenting as massive abdominal distension and respiratory embarrassment. On paracentesis, no fluid could be drained. A small lateral incision was made under local anaesthesia to drain the 'ascites', but daughter cysts typical of hydatid came out. On laparotomy, there was a cyst in the right lobe of liver which had ruptured into the peritoneal cavity leading to secondary echinococcosis.
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