Case Report

Gallbladder Hydatid Disease Complicated with Multiple Hepatobiliopancreatic Fistulae: A Case Report

Abstract

Gallbladder is a rare localization for hydatid disease. Complications are even rarer and precise diagnosis is quite difficult even with radiological assistance. We report a rare case of 41-yr-old male patient presenting with the rupture of a gallbladder hydatid cyst with multiple fistulae to intra and extrahepatic bile ducts and pancreas, at Kocaeli State Hospital, Turkey in 2021. The patient had abdominal pain and abdominal CT scan reported a bizarre “contrast enhanced cholangiography” sign - radiopaque contrast substance in gallbladder, intra and extrahepatic bile ducts and pancreatic ducts, with concomitant acute cholecystitis. Surgery was performed and intraoperatively gallbladder hydatid cyst with multiple fistulae was noted. Cholecystectomy with total cyst excision was performed. Endoscopic retrograde cholangio pancreatography (ERCP) was utilized to irrigate and eradicate the parasite in the fistulae tracts localized near pancreas and intra/extrahepatic ducts. Postoperative period was uneventful, antiparasitic treatment was started, and in the yearly follow-up patient had no recurrence. Multidisciplinary and minimal invasive management is crucial in such bizarre, complicated cases.

1. Bilgi Kırmacı M, Akay T, Özgül E, et al. Cholecysto-Hydatid Cyst Fistula: A Rare Cause of Cholangitis. Am J Case Rep. 2020;21:e921914 -1–e921914-4.
2. Yagnik VD, Dawka S, Patel N. Gallbladder Hydatid Cyst: A Review on Clinical Features, Investigations and Current Management. Clin Exp Gastroenterol. 2020;13:87-97.
3. Polat P, Kantarci M, Alper F, et al. Hydatid disease from head to toe. Radiographics. 2003;23(2):475-94.
4. Kumar R, Reddy SN, Thulkar S. Intrabiliary rupture of hydatid cyst: diagnosis with MRI and hepatobiliary isotope study. Br J Radiol. 2002;75(891):271-4.
5. Aghajanzadeh M, Ashoobi MT, Hemmati H, et al. Intrabiliary and abdominal rupture of hepatic hydatid cyst leading to biliary obstruction, cholangitis, pancreatitis, peritonitis and septicemia: a case report. J Med Case Rep. 2021;15(1):311.
6. Anderson MA, Bhati CS, Ganeshan D, et al. Hepatobiliary mucinous cystic neoplasms and mimics. Abdom Radiol (NY). 2023;48(1):79-90.
7. Saldaña C, Bolado F, González de la Higuera B, et al. Biliary stenosis secondary to fistulised hydatid cyst that mimics Klatskin tumour. Gastroenterol Hepatol. 2020;43(8):455-6.
8. McManus DP, Zhang W, Li J, et al. Echinococcosis. Lancet. 2003;362(9392):1295-304.
9. Sachar S, Sachar S, Goyal S, et al. Uncommon locations and presentations of hydatid cyst. Ann Med Health Sci Res. 2014;4 (3):447–52.
10. Kumar A, Upadhyaya DN, Singh S et al. Cholecyto-hydatid cyst fistula. Indian J Gastroenterol, 2004; 23(2): 76–7.
11. Bektasoglu HK, Hasbahceci M, Tasci Y, et al. Comparison of laparoscopic and conventional cystotomy/partial cystectomy in treatment of liver hydatidosis. BioMed Res Int. 2019; 2019:1212404.
12. Ertem M, Aytaç E, Karaduman Z. Cystic hydatid disease of the gallbladder. Turk J Gastroenterol. 2012;23(6):825–6.
13. Hamza A, Krasniqi A, Sada F, et al. ERCP treatment of obstructive jaundice caused by hydatid cyst in extrahepatic ducts 13 years after liver hydatid endocystectomy. A case report. Int J Surg Case Rep. 2020;74:38-41.
14. Sharafi SM, Sefiddashti RR, Sanei B, et al. Scolicidal agents for protoscolices of Echinococcus granulosus hydatid cyst: Review of literature. J Res Med Sci. 2017;22:92.
15. Mönnink GLE, Stijnis C, van Delden OM, et al. Percutaneous Versus Surgical Interventions for Hepatic Cystic Echinococcosis: A Systematic Review and Meta-Analysis. Cardiovasc Intervent Radiol. 2021;44(11):1689-96.
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IssueVol 18 No 3 (2023) QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/ijpa.v18i3.13766
Keywords
Gallbladder Hydatid disease Parasitology

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How to Cite
1.
Pösteki G. Gallbladder Hydatid Disease Complicated with Multiple Hepatobiliopancreatic Fistulae: A Case Report. Iran J Parasitol. 2023;18(3):414-418.