An uncommon presentation of hepatic hydatid cyst leading to biliary cirrhosis and portal hypertension
Gastroenterology and Hepatology from Bed to Bench,
9 December 2020
Hydatid disease is still one of the major current issues in endemic areas. Hydatid cysts can be seen in any organ but, liver is one of the most common involved organs. Cystobiliary communication as an overwhelming complication of hepatic hydatid cysts can contribute to the obstructive jaundice, cholangitis, sepsis and even biliary cirrhosis if left untreated. The patient we are trying to present is a 61-year-old farmer who presented with obstructive jaundice, multiple common bile duct stones and biliary cirrhosis attributed to a long-lasting untreated hepatic hydatid cyst. Portal hypertension is introduced to be an uncommon presentation of hydatid cyst. Extrinsic compression of the porta hepatis and obstruction of inferior vena cava are amongst the most important reported reasons for hydatidosis leading up to portal hypertension in the literature. Portal hypertension in the presented case is proposed to emerge from long-lasting cystobiliary communication ending in biliary cirrhosis.
- Hydatid cyst
- Cystobiliary communication
- Portal hypertension
2. Gharbi HA, Hassine W, Brauner MW, et al. Ultrasound examination of the hydatic liver. Radiology 1981; 139:459–463.
3. Ramia JM, Figueras J, De la Plaza R, et al. Cysto-biliary communication in liver hydatidosis. Langenbecks Arch Surg 2012; 397: 881–887.
4. Kilic M, Yoldas O, Koc M, et al. Can biliary-cyst communication be predicted before surgery for hepatic hydatid disease: does size matter? Am J Surg 2008; 196:732–735.
5. Baraket O, Moussa M, Ayed K, et al. Predictive factors of morbidity after surgical treatment of hydatid cyst of the liver. Arab J Gastroenterol 2014; 15: 119–122.
6. Kayaalp C, Bostanci B, Yol S, et al. Distribution of hydatid cysts into the liver with reference to cystobiliary communications and cavity-related complications. Am J Surg 2003; 185: 175–179.
7. Konca and Deniz Balci. Biliary complications of hepatic hydatid cyst surgery and prevention methods. Intechopen 2017;69031.
8. Demircan O, Baymus M, Seydaoglu G, et al. Occult cystobiliary communication presenting as postoperative biliary leakage after hydatid liver surgery: are there significant preoperative clinical predictors? Can J Surg 2006;49: 177–184.
9. El Malki HO, El Mejdoubi Y, Souadka A, et al. Predictive model of biliocystic communication in liver hydatid cysts using classification and regression tree analysis. BMC Surg 2010; 10:16.
10. Atli M, Kama NA, Yuksek YN, et al. Intrabiliary rupture of a hepatic hydatid cyst: associated clinical factors and proper management. Arch Surg 2001; 136:1249–1255.
11. Movchun AA, Koloss OE, Shatverian GA, Abdullaev AG, Alikhanov NKh. [Errors and hazards in the surgical treatment of hepatic echinococcosis]. Khirurgiia (Mosk). 1991;(11):113-7.
12. Murtaza B, Malik IB, Mahmood A, Sharif MA, Saeed S, Satti AA. Cholecysto-hydatid cyst fistula. J Coll Physicians Surg Pak. 2008;18(12):778-80.
13. Mehmet Bayrak and Yasemin Altıntas. Current approaches in the surgical treatment of liver hydatid disease: singlecenter experience. BMC Surgery. 2019;19:95.
14. J Papadimitriou, D Kannas, L Papadimitriou. Portal hypertension due to hydatid disease of the liver. Journal of the royal society of medicine. 1990;83:120-121.
15. Ali Emre, Orhan Ariogul, Aydin Alper et al. Hydatid cyst of liver and portal hypertension. HPB Surgery. 1990;2:129-133.
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