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Gallbladder Hydatid Disease Complicated with Multiple Hepatobiliopancreatic Fistulae: A Case Report
1Kocaeli State Hospital, Kocaeli, Turkey.
Insights
Hydatid disease rarely affects the gallbladder. This case details a ruptured gallbladder hydatid cyst with complex fistulae, successfully managed with surgery and endoscopic retrograde cholangiopancreatography (ERCP).
Area of Science:
- Gastroenterology
- Parasitology
- Radiology
Background:
- Gallbladder hydatid disease is exceptionally rare.
- Complications, such as fistulae, are even rarer and diagnostically challenging.
Observation:
- A 41-year-old male presented with abdominal pain and acute cholecystitis.
- CT scan revealed an unusual "contrast enhanced cholangiography" sign indicating contrast in the gallbladder, bile ducts, and pancreatic ducts.
Findings:
- Intraoperative findings confirmed a ruptured gallbladder hydatid cyst with multiple fistulae to the intra/extrahepatic bile ducts and pancreas.
- Surgical management included cholecystectomy and cyst excision, followed by ERCP for parasite eradication in fistulae.
Implications:
- Multidisciplinary and minimally invasive approaches are vital for managing complex gallbladder hydatid disease.
- Successful treatment involves surgical intervention combined with endoscopic retrograde cholangiopancreatography (ERCP) and antiparasitic therapy.
Abstract:
Gallbladder is a rare localization for hydatid disease. Complications are even rarer and precise diagnosis is quite difficult even with radiological assistance. We report a rare case of 41-yr-old male patient presenting with the rupture of a gallbladder hydatid cyst with multiple fistulae to intra and extrahepatic bile ducts and pancreas, at Kocaeli State Hospital, Turkey in 2021. The patient had abdominal pain and abdominal CT scan reported a bizarre "contrast enhanced cholangiography" sign - radiopaque contrast substance in gallbladder, intra and extrahepatic bile ducts and pancreatic ducts, with concomitant acute cholecystitis. Surgery was performed and intraoperatively gallbladder hydatid cyst with multiple fistulae was noted. Cholecystectomy with total cyst excision was performed. Endoscopic retrograde cholangio pancreatography (ERCP) was utilized to irrigate and eradicate the parasite in the fistulae tracts localized near pancreas and intra/extrahepatic ducts. Postoperative period was uneventful, antiparasitic treatment was started, and in the yearly follow-up patient had no recurrence. Multidisciplinary and minimal invasive management is crucial in such bizarre, complicated cases.
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