Hepatic hydatid disease with spontaneous rupture into the ileum: a rare case report

Cystic echinococcosis is a parasitic infection endemic in many regions, with the liver being the most commonly affected organ. Although complications such as biliary rupture are well known, fistulization into the small intestine-especially the ileum-is extremely rare. We report a case of a 65-year-old man with a history of hepatic hydatid disease who presented with right upper quadrant pain and fever. Imaging revealed 2 hepatic cystic lesions, 1 complicated by an air-fluid collection and fistulization into the ileum. Surgical treatment included subtotal cystectomy, drainage, and fistula closure. This case highlights the diagnostic value of imaging in detecting rare complications of hydatid disease, underscores the diverse clinical presentations of this condition, and reinforces the importance of timely surgical management.