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Case Reports
. 2021 May 28;15(1):311.
doi: 10.1186/s13256-021-02822-5.

Intrabiliary and abdominal rupture of hepatic hydatid cyst leading to biliary obstruction, cholangitis, pancreatitis, peritonitis and septicemia: a case report

Manouchehr Aghajanzadeh  1 , Mohammad Taghi Ashoobi  2 , Hossein Hemmati  3 , Pirooz Samidoust  3 , Mohammad Sadegh Esmaeili Delshad  3 , Yousha Pourahmadi  1
Affiliations
Case Reports

Intrabiliary and abdominal rupture of hepatic hydatid cyst leading to biliary obstruction, cholangitis, pancreatitis, peritonitis and septicemia: a case report

Manouchehr Aghajanzadeh et al. J Med Case Rep. .

Abstract

Background: Hydatid cysts are fluid-filled sacs containing immature forms of parastic tapeworms of the genus Echinococcus. The most prevalent and serious complication of hydatid disease is intrabiliary rupture, also known as cystobiliary fistulae. In this study, a sporadic case of biliary obstruction, cholangitis, and septicemia is described secondary to hydatid cyst rupture into the common bile duct and intraperitoneal cavity.

Case presentation: A 21-year-old Iranian man was admitted to the emergency ward with 5 days of serious sickness and a history of right upper quadrant abdominal pain, fatigue, fever, icterus, vomiting, and no appetite. In the physical examination, abdominal tenderness was detected in all four quadrants and in the scleral icterus. Abdominal ultrasound revealed intrahepatic and extrahepatic biliary duct dilation. Gallbladder wall thickening was normal but was very dilated, and large unilocular intact hepatic cysts were detected in segment IV and another one segment II which had detached laminated membranes and was a ruptured or complicated liver cyst.

Conclusion: Intrabiliary perforation of the liver hydatid cyst is an infrequent event but has severe consequences. Therefore, when patients complain of abdominal pain, fever, peritonitis, decreased appetite, and jaundice, a differential diagnosis of hydatid disease needs to be taken into consideration. Early diagnosis of complications and aggressive treatments, such as endoscopic retrograde cholangiopancreatography and surgery, are vital.

Keywords: Hydatid cyst; Intrabiliary rupture; Liver.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Computed tomography scan of the liver showing two cysts in segments II and VII, respectively, with septation, of which one was intact and the other had ruptured
Fig. 2
Fig. 2
Axial contrast enhanced computed tomography scan showing unilocular hepatic cysts with detached laminated membranes compatible with hepatic hydatid cysts on segments II and IV. Intrahepatic biliary duct dilation is also seen
Fig. 3
Fig. 3
Magnetic resonance cholangiopancreatography shows cyst rupture into the common hydatid cyst membranes and hepatic duct in the common bile duct. A hydatid cyst was also observed on segment II. Laparotomy and common biliary duct exploration established that the bile duct was obstructed with hydatid membranes and daughter cysts
Fig. 4
Fig. 4
Pus from collected after exploration of common bilary duct and dilated gallbladder and T-tube cholangiography
See this image and copyright information in PMC

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References

    1. Aghajanzadeh M, Asgary MR, Foumani AA, Alavi SE, Rimaz S, Banihashemi Z, et al. Surgical management of pleural complications of lung and liver hydatid cysts in 34 patients. Int J Life Sci. 2014;8:15–19. doi: 10.3126/ijls.v8i4.10893. - DOI
    1. Aghajanzadeh M, Safarpoor F, Amani H, Alavi A. One-stage procedure for lung and liver hydatid cysts. Asian Cardiovasc Thorac Ann. 2008;16:392–395. doi: 10.1177/021849230801600510. - DOI - PubMed
    1. Spârchez Z, Osian G, Onica A, Bărbântă C, Tanţău M, Pascu O. Ruptured hydatid cyst of the liver with biliary obstruction: presentation of a case and review of the literature. Rom J Gastroenterol. 2004;13:245–250. - PubMed
    1. Atli M, Kama NA, Yuksek YN, Doganay M, Gozalan U, Kologlu M, et al. Intrabiliary rupture of a hepatic hydatid cyst: associated clinical factors and proper management. Arch Surg. 2001;136:1249–1255. doi: 10.1001/archsurg.136.11.1249. - DOI - PubMed
    1. Avcu S, Ünal Ö, Arslan H. Intrabiliary rupture of liver hydatid cyst: a case report and review of the literature. Cases J. 2009;2:6455. doi: 10.1186/1757-1626-2-6455. - DOI - PMC - PubMed

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