Orbital Echinococcosis Presenting After Mandibular Trauma: Management of Intraoperative Rupture with Chlorhexidine and Hypertonic Saline Adjuncts in a Rural Jordanian Patient

Abstract

A Hydatid cyst is a parasitic infection caused by the tapeworm Echinococcus granulosus. This infection typically results in the formation of cysts, primarily in the liver or lungs, and rarely in other organs.
We present a rare case of orbital hydatid cyst in 19‐year‐old male from a rural area in Jordan who initially presented with a mandibular swelling that emerged after blunt trauma from a wooden object. Subsequent biopsy and histopathological analysis of the mandibular lesion confirmed a hydatid cyst. Soon thereafter, the patient developed significant proptosis and signs of optic nerve compromise, with imaging revealing a large cystic mass extending from the orbital apex, displacing intra-orbital structures.
The patient underwent surgery after a two-week course of preoperative albendazole. An excision was performed through an extended skin crease incision. During surgery, the cyst ruptured, requiring immediate aspiration and irrigation with chlorhexidine and hypertonic saline. Postoperatively, the patient continued albendazole for four weeks. The patient experienced notable resolution of proptosis and a marked restoration of visual acuity.
Maintaining a high index of suspicion for hydatid disease in endemic regions is of critical importance, particularly when atypical presentations such as post-traumatic mandibular involvement occur. Moreover, this case highlights how effective interdisciplinary collaboration and adaptive surgical techniques can yield favorable outcomes even in resource-limited environments.