Complete extraction of a long hepatic hydatid cyst with endoscopic retrograde cholangiography

Hydatid disease or echinococcosis is a systemic zoonosis caused by Echinococcus granulosus larvae. We report the case of a 63 year-old Peruvian female patient who presented with diffuse abdominal pain and jaundice. An abdominal computed tomography (CT) scan was performed that showed a large hepatic hydatid cyst (6 x 6 cm) in segment IV with an apparent communication with the biliary duct. Laboratory results showed hemoglobin 13.2 g/dl, white blood cell (WBC) count 10,600 cell/mm3, normal serum amylase and lipase, total bilirubin 7,5 mg/dl, direct bilirubin 6,2 mg/dl and alkaline phosphatase 234 UI/l. Magnetic resonance cholangiopancreatography (MRCP) showed the same findings of the CT scan plus dilation of the biliary duct.