Intrabiliary rupture of hepatic hydatid cyst: Sonographic and cholangiographic appearances

Abstract

Sonographic and cholangiographic appearances of confirmed intrabiliary rupture of a hepatic hydatid cyst were studied in 15 cases. Sonographic findings included liver cyst in all cases; nonshadowing echogenic structures in the dilated biliary tree representing hydatid material, such as fragmented membranes, sand, matrix, and daughter vesicles, in eight cases; and loss of continuity of the cyst wall adjacent to the bile duct representing the site of communication in seven cases. Cholangiographic findings were as follows: filling defects of varying size and shapes in the dilated biliary tree in 13 cases, and changing shape and position of these filling defects in three of them; and leakage of contrast medium into the cyst cavity in 12 cases. Intrabiliary rupture of hepatic hydatid cyst was suggested by sonography in 10 cases (66.7%) and at cholangiography in 13 cases (86.6%). We conclude that a joint application of sonography and endoscopic cholangiography is mandatory for proper preoperative evaluation of this disorder.

Hydatid Disease: Current Status and Recent Advances

“…17 Cyst rupture into the biliary tree causes obstruction of the ducts by daughter cysts and laminated membranes and presents as biliary colic, cholangitis and progressive cholestasis. 18 Cyst contents may block the ampullary orifice causing acute pancreatitis. Cyst rupture into the peritoneum causes immediate life-threatening anaphylaxis and if the person survives, the scoleces implant on the peritoneal surface resulting in extensive peritoneal hydatidosis.…”

“…The selection of these tools depend upon the organ to be imaged, the status of the cyst (intact, ruptured or infected) and adjacent structures which need to be assessed. 2,18,29 Plain radiography has a role in lung and bone cysts. A plain film of chest shows intact cyst as sharply demarcated round-to-oval homogenous mass of variable size.…”

Outcome of albendazole therapy in the management of hepatic hydatid disease

“…Acute, severe abdominal pain does occur occasionally and usually indicates rupture, biliary complications or secondary bacterial infection. 5 Ultrasonography is the best and safest diagnostic tool as it can be used to recognize cysts as small as 1 cm in diameter. 1 Computed tomography abdomen has a sensitivity of 100% in detecting liver cyst and helps in accurate anatomic localization of cysts.…”

Role of endoscopic retrograde cholangiography in ruptured hepatic hydatid cyst

“…1 However, it is less often reported on imaging. 2 This is due to the occult nature of most intrabiliary ruptures. 3 These cases remain clinically silent.…”