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Case Reports
. 2024 May 11:25:e943893.
doi: 10.12659/AJCR.943893.

Intrabiliary Rupture of a Hepatic Hydatid Cyst: A Case Report

Maissa Jellali  1 , Hanen Zenati  1 , Mohamed Zayati  1 , Ibtissem Korbi  1 , Faouzi Noomen  1
Affiliations
Case Reports

Intrabiliary Rupture of a Hepatic Hydatid Cyst: A Case Report

Maissa Jellali et al. Am J Case Rep. .

Abstract

BACKGROUND Hydatid disease is a common parasitic infection in many areas of Asia, South America, and Africa. It can affect any organ, most commonly the liver. The hydatid is often asymptomatic and the diagnosis is made when complications arise. The most common complication of this disease is opening in the bile ducts, which is a life-threatening condition causing serious acute cholangitis. We report a case of acute cholangitis caused by hydatid cyst rupture into the right bile duct. CASE REPORT A 33-year-old woman, with no medical or surgical history, presented to our Emergency Department with abdominal pain, jaundice, and fever for 3 days prior to admission. The patient was hemodynamically stable. In the examination, we noticed right upper-quadrant tenderness with guarding, icterus sclera, and negative Murphy sign. A CT scan showed a liver hydatid cyst of the 4th and 8th of segments, with intrahepatic and extrahepatic biliary duct dilation. The cyst communicated with the right hepatic bile duct via a large fistula. A diagnosis of acute cholangitis was made and she underwent conservative treatment with external drainage of the pericystic cavity through the biliary duct. The postoperative course was uncomplicated and she was discharged 15 days later. CONCLUSIONS The surgical approach to hepatic hydatid must be customized based on the specific characteristics of the cyst and associated complications. Acute hydatid cholangitis is a rare but serious complication of a hydatid cyst, which requires early diagnosis and adequate surgical management.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1.
Figure 1.
Abdominal CT showing hydatid cyst of 4th and 8th liver segments with intrahepatic ductal dilatation.
Figure 2.
Figure 2.
CT scan illustrating the communication between the hydatid cyst and the right bile duct.
Figure 3.
Figure 3.
Operative view showing a hydatid disease of the common bile duct after choledochotomy.
Figure 4.
Figure 4.
Intra-operative cholangiography demonstrating common bile duct obstruction and communication with right bile duct.
Figure 5.
Figure 5.
Postoperative cholangiography showing a narrow common bile duct without lacunae and a good duodenal passage.
Figure 6.
Figure 6.
Control CT scan showing subsidence of the residual cavity.
See this image and copyright information in PMC

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