Presentation
Acute right hypochondriac pain, fever, jaundice, and tenderness.
Patient Data
Hepatic enhanced wall of complex cyst in segments 5-8 with multiple small internal cysts inside as daughter cysts given a honeycomb appearance.
A defect in its wall at the posteromedial connected to the biliary duct dilated small cysts inside and filled the intra and extra-hepatic biliary duct including CBD till the opening at 2nd part of the duodenum.
Other abdominal and pelvic organs are unremarkable.
Case Discussion
This is a case of hepatic hydatid cyst stage III with dilated intra and extra-hepatic biliary ducts.
Clinically, Charcot's triad of fever, jaundice, and right hypochondria pain, along with the imaging findings, raise the possibility of secondary infected cholangitis as a result of intrabiliary rupture of hepatic hydatid cyst.
ERCP is recommended to confirm and also for further surgical workup.
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