Objective: To present a case of hepatic hydatid cyst with a biliary communication that was not suitable for surgery and hence necessitated sclerotherapy with absolute alcohol after occluding the biliary communication with a balloon catheter. Clinical Presentation and Intervention: A 50-year-old Asian man presented to the surgical emergency department with a 1-year history of repeated attacks of obstructive jaundice and right hypochondrial pain. Ultrasound and contrast computed tomography revealed a cyst, and endoscopic retrograde cholangiopancreatography and cystography revealed a biliocystic communication. An indirect hemagglutination test for echinococcosis showed the presence of antibodies to Echinococcus species at a titer of 8 establishing the diagnosis of hydatid cyst. Although surgery is the accepted modality of treatment in these cases, the patient was deemed unfit for surgery due to his underlying cardiac problem. While percutaneous treatment with absolute alcohol is contraindicated in his case, it was successfully attempted after balloon occlusion of the biliocystic communication. Conclusion: This case showed that in this patient with hepatic hydatid disease and biliocystic communication, who was not fit for surgery, percutaneous sclerotherapy with absolute alcohol after balloon occlusion was successfully performed by an interventional radiologist.

Aortic dissection remains one of the rare but life-threatening causes of chest pain presenting to the emergency department.

A space-occupying lesion of the brain is commonly due to malignancy but could be other underlying pathologies as well [1]. The effects of SOL may be local or due to compression of adjacent brain structures. Patients may also have behavioral disturbances or cognitive dysfunction [2,3]. Aims & Objectives:1. To identify SOL patients presenting with elusive symptoms in Emergency Department. 2. To avoid diagnostic delay of SOL.