ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Obstructive jaundice caused by intrabiliary rupture of a hydatic cyst

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Echinococcosis is a human parasitic disease, seen mostly in the Mediterranean area, Eastern Europe, Middle East, South America and North Africa. The liver is the most common site of hydatic cyst. Intrahepatic rupture is the most common complication of the liver echinococcosis.
A 48-years old female, who had undergone cholecystectomy 10 days ago, arrived at the Emergency Room with jaundice, epigastric and right upper quadrant pain, nausea, vomiting and fever.
Laboratory showed leukocytosis with eosinophilia, increased values of the liver test (transaminases, alcalin phosphatase, gamma glutamyl transferase, total and direct bilirubin). Abdominal CT scan revealed a left lobe hydatic liver (segment II) in contact with the left biliary duct and dilatation of the biliary tree. ERCP showed cystic membrane in the common bile duct, so we performed papillotomy and extraction of the hydatic elements from the biliary tract. 5 days after ERCP we removed surgically the hepatic cyst, which had a communication with the left hepatic duct. We performed pericystectomy and suture of the left duct.

Conclusions: Hydatic elements in the biliary tract can be a cause of obstructive jaundice in the endemic area. ERCP may be beneficial, but surgery remains the treatment of choice for treatment of liver hydatid cysts.

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