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Case Reports
. 2011;24(4):328-330.

Complicated hepatic hydatid cyst with simultaneous biliary tree and intraperitoneal rupture: can we treat it in a minimally invasive way?

Georgios Germanidis  1 , Konstantinos Mantzoukis  1 , Tasos Kelekis  2 , Eleni Doumaki  3 , Konstantinos Vasiliou  1 , Ioannis Kokinakis  3 , Pantelis Zebekakis  3 , Pavlos Nikolaidis  3
Affiliations
Case Reports

Complicated hepatic hydatid cyst with simultaneous biliary tree and intraperitoneal rupture: can we treat it in a minimally invasive way?

Georgios Germanidis et al. Ann Gastroenterol. 2011.

Abstract

We report a case of complicated liver hydatid cyst with biliary system communication, cholangitis, and having at the same time simultaneous free intraperitoneal rupture. This very rare case was treated successfully by a minimally invasive method, namely ERCP, large sphincterotomy and bile duct decompression by cysts and membranes, percutaneous radiologic subdiaphragmatic drainage and prolonged medical treatment with albendazole. Our patient, an 87-year-old lady, was considered unfit for open or laparoscopic surgery because of her poor general condition, although surgery represents the common practice in such cases.

Keywords: ERCP; cholangitis; complicated hydatid cyst; drainage.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
ERCP revealing at least five round bile duct contents (hydatid cysts and membranes)
Figure 2
Figure 2
CT scan showing pleural effusion and large diffuse peritoneal effusion around the liver. Air is present inside the hydatid cyst
Figure 3
Figure 3
Plain x-ray showing complete absorption of pleural effusion. A percutaneous subdiaphragmatic drainage is also noted
Figure 4
Figure 4
Follow up CT scan with absence of ascites
See this image and copyright information in PMC

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