Kist hidatiğin nadir prezantasyonu: hepatik arter psödoanevrizma kanaması ve senkron duodenal fistül

Aims: Hydatid cyst disease is a rare cause of upper gastrointestinal bleeding. Peculiarly if it's resulted from ruptured hepatic artery aneurysm in the hydatid cavity which fistulated into duodenum. We here present case pseudoaneurysm due to complicated with synchronous duodenal fistula. 
 Case: A 45-year-old male was admitted emergency department hematemesis and hematochezia. The patient had history liver surgical procedure lung ecinoccosis. Endoscopy revealed an unusual ulcerated lesion Yellow membranes were observed midst blood oozing. After unsuccessful endoscopic sclerotherapy, Computerized Tomography (CT) performed. CT duodenum bleeding formed pseudoaneurysm. Hepatic coil embolization performed urgently percutaneous transhepatic drainage catheter applied maintain bile flow. Subsequently, 10 Fr , cm plastic stent inserted via Endoscopic Retrograde Cholangiopancreatography (ERCP). complication after abscess. Although initially, wasn’t successful. As last option, debridement considered.
 Conclusion: If who presented previous cyst, complications must be listed as differential diagnosis. Besides endoscopy, contrast-enhanced ЕRCP are essential diagnostic therapeutic approaches.