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Intrabiliary rupture of hepatic hydatid cyst

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Jaundice and right upper quadrant pain.

Patient Data

Age: 55 years
Gender: Female

A 78×68mm thick-walled partially exophytic cystic lesion with internal layer detachment is noted in the inferolateral aspect of the right liver lobe inferring hydatid cyst. In addition, intra and extra hepatic bile ducts are dilated and CBD measured 22 mm in caliber, contains low signal linear structures highly suggestive of the intraductal rupture of the hepatic hydatid cyst.

Case Discussion

Intrabiliary rupture of hepatic hydatid cyst is not rare and may cause cholangitis, obstructive jaundice and even life-threatening sepsis.

On imaging, diagnosis suggested by direct visualization of cystobiliary communication or indirect findings such as a break in cyst wall adjacent to a bile duct, biliary tree dilatation, cystic material within the biliary tree or gallbladder and presence of gas-fluid or fat-fluid level within the cyst.

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