Intrabiliary rupture of calcified hepatic hydatid cyst

Case contributed by Dr Vinay V Belaval

Presentation

Obstructive jaundice.

Patient Data

Age: 50 years
Gender: Female

Axial and coronal T2W images of biliary system show an irregular wedge-shaped, hyperintense cystic lesion in segment II of the liver with curvilinear T2 hypointense foci. The cystic lesion was seen directly extending into left hepatic duct with extension of T2W hypointensities into common hepatic duct resulting in mild right and moderate left upstream intrahepatic biliary dilatation. 

These features are consistent with intrabiliary rupture of hepatic hydatid cyst causing obstructive biliopathy. 

Calcified irregular shaped lesion is seen in segment II of the liver, extending into left hepatic duct and common hepatic duct causing obstructive biliopathy - consistent with intrabiliary rupture of calcified hepatic hydatid cyst.

Case Discussion

Hepatic hydatid cyst can undergo three types of rupture; contained, communicating and direct.

  • contained rupture is endocyst rupture, seen as floating membranes within the intact pericyst
  • communicating rupture is the most common type characterized by intrabiliary rupture resulting in obstructive jaundice
  • direct rupture into the peritoneal cavity 

CT and MRI are complementary to each other in diagnosing complications of hepatic hydatid cyst.

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Case information

rID: 69074
Published: 27th Jun 2019
Last edited: 28th Jun 2019
Inclusion in quiz mode: Included
Institution: Belcity Scan and Diagnostic Centre

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