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Case Reports
. 2020:73:199-202.
doi: 10.1016/j.ijscr.2020.07.036. Epub 2020 Jul 16.

Hepato-pericardial fistula revealed by a massive pericardial effusion: A case report of an exceptional complication of the hydatid liver cyst

Ayoub Abetti  1 , Selma Lyazidi  2 , Zakaria Qechchar  3 , Rachida Habbal  3 , Youssef Ettaoumi  2
Affiliations
Case Reports

Hepato-pericardial fistula revealed by a massive pericardial effusion: A case report of an exceptional complication of the hydatid liver cyst

Ayoub Abetti et al. Int J Surg Case Rep. 2020.

Abstract

Introduction: The rupture of the hydatid liver cyst in the pericardium is a very exceptional and serious complication that can cause sudden death following cardiac tamponade or anaphylactic shock.

Case presentation: We report a case of a 25 years-old woman with a massive pericardial effusion due to fistulization of hepatic hydatid cyst. Surgical closure of the fistula and the resection of the tow hydatid cysts were successful in managing this rare case.

Discussion: Hepato-pericardial fistula is an extremely rare complication of hydatid liver cyst. Only 6 similar cases were previously reported in the literature. The Hepato-pericardial fistula may result in an acute pericarditis that progress to either cardiac tamponade or constrictive pericarditis. Its diagnosis is based on ultrasound and CT imaging. The surgical treatment with supportive therapy seems to improve the outcomes.

Conclusion: Pericardial effusion secondary to rupture of hepatic hydatid cyst should always be suspected in endemic countries.

Keywords: Case report; Fistula; Hydatid cyst; Liver; Pericardial effusion.

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Figures

Fig. 1
Fig. 1
Echographic image in the subxiphoid view showing a large pericardial effusion containing daughter vesicles.
Fig. 2
Fig. 2
Thoracic CT angiography in coronal section, showing the hydatid cyst of segment II communicating with the pericardium through a thin aperture causing a large pericardial effusion.
Fig. 3
Fig. 3
Perioperative view showing the thickened pericardium.
Fig. 4
Fig. 4
(A, B): Perioperative view showing the exit of the daughter vesicles through the transdiaphragmatic fistula.
Fig. 5
Fig. 5
An image of the liver hydatid cyst after surgical resection.
See this image and copyright information in PMC

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