Radiologic and endoscopic appearance of intrabiliary rupture of hydatid liver disease

Intrabiliary rupture of hydatid liver cyst was diagnosed in 6 patients presenting with obstructive jaundice. All patients underwent ultrasonography and endoscopic retrograde cholangiopancreatography prior to surgical drainage of the liver cyst. Hydatid debris were found in the common bile duct preoperatively in 3 patients, and postoperatively in an additional 3 patients. Accurate diagnosis was made in all patients based on combined duodenoscopic, cholangiographic and sonographic findings. It is concluded that the combination of ultrasonography and endoscopic retrograde cholangiopancreatography can accurately detect intrabiliary rupture of hydatid liver cyst and that both techniques should be performed early in the investigation of suspected ruptured hydatid liver cyst.