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17 June 2020 : Case report  Turkey

Cholecysto-Hydatid Cyst Fistula: A Rare Cause of Cholangitis

Rare disease

Mehlika Bilgi Kırmacı1ABEF*, Tamer Akay2ABEG, Esra Özgül3BCD, Sezgin Yılmaz1ABCDEF

DOI: 10.12659/AJCR.921914

Am J Case Rep 2020; 21:e921914

Abstract

BACKGROUND: Cholecysto-hydatid fistula is a rare complication of liver echinococcosis; suppurative cholangitis due to cholecysto-hydatid fistula is even rarer. A multidisciplinary approach is required by radiology and surgery departments during the preoperative diagnosis and treatment processes of these cases. In this paper, a patient treated with suppurative cholangitis due to cholecysto-hydatid fistula is presented.

CASE REPORT: A 76-year-old female patient was admitted to emergency services due to cholangitis. Abdominal computerized tomography (CT) examination revealed that the common bile duct was dilated through the right liver in a wide and torsional pattern; the gallbladder cleaved into hepatic flexura and its wall became irregular. There was a cystic appearance 10×13×12 cm in size on the lateral segment of the left liver lobe. Endoscopic retrograde cholangiopancreatography (ERCP) was performed, and it showed the communication between the hydatid cyst pouch and the bile duct. The patient was taken to open surgery, which confirmed the imaging findings. The gallbladder and the adjacent cyst were excised, and a T-tube was placed in the choledochus. Postoperative recovery was uneventful.

CONCLUSIONS: We suggest that cholecysto-hydatid fistula is a severe problem that requires close workup with both the radiology and surgery departments. Preoperative ERCP is beneficial for the visualization of the fistulization between gallbladder and hydatid cyst and for the treatment of suppurative cholangitis.

Keywords: Biliary Fistula, Cholangiopancreatography, Endoscopic Retrograde, Cholangitis, Echinococcosis, Hepatic, gallbladder diseases, Aged, Echinococcosis, Fistula

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923