Resolution of Intrabiliary Ruptured Hepatic Hydatid Cyst after Endoscopic Extraction: Case Report
Journal Title: Medical Journal of Clinical Trials & Case Studies - Year 2017, Vol 1, Issue 3
Abstract
Hepatic hydatid cyst may rupture into bile ducts in 4-20% of cases leading to cholestasis in 2/3 of cases. We tried to prove that ERCP can replace surgery in treatment of intrabiliary ruptured hydatid cyst. Our patient was 42 years old male with cholestasis, abdominal ultrasonography showed hypoechoic lesion at postero-inferior aspect of right lobe related to dilated CBD, total bilirubin 26.1 mg/ dl, direct bilirubin 18.8 mg/dl. MDCT revealed ovoid cystic lesion in right lobe, serology for hydatid was positive. Cyst was seen communicating with confluence of hepatic ducts. During ERCP, membranes were seen coming out of papilla of Vater, on injection of contrast; communication of biliary tree with cyst was established. Endoscopic papillotomy was performed and cannulation of bile duct reached abscess cavity with aspiration of yellowish green fluid, bacteriological examination of this fluid showed pseudomonas aeruginosa. Large amount of membranes were removed from CBD and sent for histopathology which showed picture of hydatid cyst. Procedure was completed with CBD stenting. Single course of Albendazole was given. Follow up after one month showed marked improvement of patient's general condition with drop of TLC and bilirubin. Follow up MDCT showed marked regression in size of previously described lesion. One month later, additional drop of bilirubin was achieved. Abdominal ultrasonography showed complete resolution of cyst confirmed by ERCP revealing start of cyst calcification with obliteration of its cavity and stent was removed. We concluded that therapeutic ERCP may replace surgery in treatment of intrabiliary rupture of hepatic hydatid cyst.
Authors and Affiliations
Ashraf Abdel Azeem M*
Keywords
Related Articles
- EP ID EP751959
- DOI 10.23880/mjccs-16000113
- Views 15
- Downloads 0
Aging Problem of the Patient Population on Maintenance Hemodialysis: An Important Issue for Clinical Nephrology to Focus Upon
Hemodialysis (HD) is now an indispensable medical treatment; it is very often introduced to treat end-stage renal disease (ESRD). Kidney transplantation and continuous ambulatory peritoneal dialysis (CAPD), which are...
Acute Hemorrhagic Edema of Infancy in a 9 Months Old Child: A Case Report
Acute Haemorrhagic edema of infancy (AHEI) is a benign cutaneous condition. It typically presents as low grade fever, purpuric or macular rash and non pitting edema of limbs and face. Its cutaneous manifestations are a...
Ultrasound Diagnosis in Assessment of Structures and Functional Disorders in Distal Gastric Cancer
Objective: To evaluate the diagnostic possibilities of transabdominal ultrasonography for evaluation of severity of structures and functional disorders in distal gastric cancer (DGC). Materials and Methods: An analysis...
Innovative Formula for Management of Dermatological Disorders Associated with Chediak Higashi
Chediak-Higashi syndrome is a rare autosomal recessive condition with variant stages of systemic manifestations. To date, the management of skin lesions depends mainly upon antibiotics and corticosteroids. The current s...
Investigation of the Association of Blood Pressure with Some Haematological Parameters of University Students of Niger Delta Descendant, Nigeria
It is generally believed that functional disturbances of body systems could possibly influence the body blood pressures and thus, could as well alter some hematological parameters of an individual in stressed condition....