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Hepatic Hydatid Cyst With Cystobiliary Communication and Cystoduodenal Fistula
Oseen Shaikh1, Naveen Kumar Gaur1, Chellappa Vijayakumar1
1Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.
Insights
This case study details a rare hepatic hydatid cyst complication involving a cystobiliary communication and duodenal fistula. Surgical intervention led to successful patient recovery without recurrence.
Area of Science:
- Hepatology
- Surgical Gastroenterology
- Parasitology
Background:
- Hepatic hydatid cyst (HHC) is a parasitic infection primarily affecting the liver.
- Complications such as cystobiliary communication (CBC) and fistulas are infrequent but significant.
- This report focuses on a rare instance of HHC with both CBC and a cystoduodenal fistula.
Observation:
- A 48-year-old male presented with a diagnosed HHC.
- The patient exhibited both a cystobiliary communication and a cystoduodenal fistula.
- Diagnostic confirmation involved intraoperative visualization of the CBC.
Findings:
- The patient underwent a partial cystectomy for the hepatic hydatid cyst.
- Cystobiliary communication was confirmed intraoperatively and successfully closed.
- The cystoduodenal fistula was surgically repaired using an omental patch (Graham patch).
Implications:
- This case highlights successful surgical management of a rare HHC complication.
- Effective treatment involved combined closure of CBC and duodenal fistula.
- The patient experienced a favorable outcome with no recurrence during a five-month follow-up period.
Abstract:
The liver is the most common site affected by hydatid disease. Hepatic hydatid cyst (HHC) with cystoduodenal fistula is an unusual and infrequent complication. We present a 48-year-male diagnosed with an HHC with cystobiliary communication (CBC) and cystoduodenal fistula. The patient underwent partial cystectomy. Intraoperative demonstration of CBC was done with injection propofol, followed by primary closure of the CBC. The duodenal fistula was closed primarily with an omental patch, also known as a Graham patch. The patient improved well without any complications, and there was no recurrence of the symptoms for the subsequent five-month follow-up.
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