Pancreatic abscess due to infected hydatid disease

A 35-year-old man sought treatment for acute epigastric pain, mild jaundice, and high fever. The patient was alcoholic and had been treated for a week in another hospital, at which time the clinical findings and indirect laboratory test indicated an attack of acute pancreatitis. At admission to the surgical intensive care unit of Aretaieon Hospital, the patient was in a septic condition; a computed tomographic scan of the upper abdomen revealed an abscess at the head of the pancreas. Surgical exploration showed an infected hydatid cyst at the head of the pancreas and pancreatic edema. The cyst was evacuated and drained, which resulted in formation of an external pancreatic fistula. Fistulography showed a communication of the residual cavity with the main pancreatic duct. The patient was begun on a regimen of somatostatin infusion, and the fistula closed within 3 days. The patient was discharged on the sixteenth postoperative day and has remained in good health for a year.