Pancreatic cystic echinococcosis causing acute pancreatitis

Abstract

Echinococcosis is a zoonotic infestation, most commonly arises from Echinococcus granulosus helminth. The definitive hosts are carnivora, such as dogs and cats, and the intermediate hosts are herbivores, including cattle, sheep and goats. Humans are intermediate hosts, causing cystic echinococcosis. In our country, the incidence of echinococcos is 14%. The disease is localized in the liver by 70%. Cyst hydatid localized in the pancreas is unusual, with an incidence of 0.2-0.6%, and rarely causes acute pancreatitis. In this report, we present a 45-year-old male patient with cyst hydatid, which manifested by an acute pancreatitis attack. In the examination, there was a CE2 type according to WHO classification stage III cyst hydatid of 97 mm diameter with septa associated with Wirsung duct, acute pancreatitis and splenomegaly. The indirect hemagglutination test was >1: 2560. The patient underwent pancreatectomy and splenectomy following medical therapy with Albendazole tablet for four weeks. IHA of the patient was found as 1/32 in the third month. Cyst hydatid should be considered in the differential diagnosis of all cystic masses, especially in the regions where the disease is endemic. In addition, it should be remembered that although rarely seen, pancreatic cyst hydatid may cause acute pancreatitis.