Pancreatic hydatid cyst masquerading as a choledochal cyst

Area of Science:

• Pediatric Surgery
• Hepatobiliary Surgery
• Parasitology

Background:

• Obstructive jaundice in children can stem from various causes, including choledochal cysts.
• Accurate preoperative diagnosis is crucial for effective surgical planning and management.
• Hydatid disease, caused by Echinococcus granulosus, is endemic in certain geographic areas.

Observation:

• A 6-year-old boy presented with recurrent fever, abdominal pain, and obstructive jaundice.
• Initial clinical and imaging findings suggested a type I choledochal cyst.
• Surgical exploration revealed a hydatid cyst in the pancreatic head obstructing the common bile duct.

Findings:

• The surgical findings differed from the preoperative diagnosis, identifying a hydatid cyst instead of a choledochal cyst.
• The hydatid cyst's location in the pancreatic head was responsible for the common bile duct obstruction.
• This case underscores a rare presentation of hydatid disease in pediatric patients.

Implications:

• In endemic areas, hydatid cysts must be considered in the differential diagnosis of pediatric obstructive jaundice.
• Cystic lesions around the bilio-pancreatic junction in children warrant a broad differential, including parasitic infections.
• Increased awareness can lead to earlier diagnosis and appropriate treatment of hydatid disease in children.