Cholecysto-Hydatid Fistula Complicated by Cholecystitis and Acute Rupture Hydatid Cyst into Peritoneal Cavity- A Case Report

Introduction: Cholecysto-hydatid fistula is a very rare complication of liver echinococcosis. We report the case of a patient with hydatid cyst fistula to the gallbladder accompanied by cholecystitis. Patient information: 50-year-old patient admitted to emergency department due to pain in the upper right abdominal quadrant. Imaging studies (ultrasound, CT) showed parasitic cyst in the IV segment of the liver coexisting with a fistula with an inflamed gallbladder, as well as two other smaller cysts. Intra operatively rupture of the cyst into the peritoneal cavity was observed. Excision of the gallbladder and the adjacent cyst en bloc was performed. Histopatological examination revealed protoscolices of Echinococcus granulosus. In the postoperative period complicated such as severe bacteremia, wound suppuration and intraperitoneal abscesses developed, despite the use of antibiotic therapy. Spectacular clinical improvement was achieved after using polyclonal immunoglobulin. Conclusion: Echinococcosis is disease with an insidious course. Communication of hydatid cysts with the biliary tract can cause a severe clinical course with numerous complications.