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Article Details

Clinical Image

Volume 4, Issue 2 (February Issue)

Multiple Hydatid Cysts Rupturing into the Biliary Tree

Krithi Krishna Koduri1, Mithun Sharma2*, Mohan Ramchandani1, Anand V Kulkarni2 and Duvurr Nageshwar Reddy1

1Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India

2Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India

*Corresponding author: Mithun Sharma, Director Hepatology and Regenerative Medicine, Asian Institute of Gastroenterology, Hyderabad, India. E-mail: drmithunsharma@gmail.com

Received: February 25, 2022; Accepted: March 04, 2022; Published: March 26, 2022

Citation: Koduri KK, Sharma M, Ramchandani M, et al. Multiple Hydatid Cysts Rupturing into the Biliary Tree. Clin Image Case Rep J. 2022; 4(2): 219.

Multiple Hydatid Cysts Rupturing into the Biliary Tree
Abstract

A 59 year old gentleman, presented with a 6-month history of dull right hypochondrial pain and one month of low-grade intermittent fever with jaundice. His total bilirubin was 3.2 md/dl with direct bilirubin – 2.1 mg/dl (reference: 0.8-1.2 milligram/decilitre) and elevated serum alkaline-phosphatase [367 IU/L (reference: 40-120IU/L)]. Computed-tomography (CT) of abdomen showed 3 well-defined hypodense lesions in segments I, III, and VI (Panel A1-A4). Segment III lesion ruptured into left hepatic duct extending to common hepatic duct and common bile-duct (CBD) showing internal heterogenous membrane (Panel A4) with upstream intrahepatic biliary dilatation (Panel A2). Side-viewing endoscopy showed the hydatid membranes protruding out of papilla (Panel B). He underwent endoscopic retrograde-cholangio-pancreatography wherein biliary balloon sweep and CBD stenting was done. His echinococcal immunoglobulin G was positive. He was started on oral albendazole and planned for surgery. This is an unusual endoscopic finding in hydatid cyst of liver.