Hydatid Disease Presenting as Pancreatitis

A 20 year old Turkish man presented with a one year history of weight loss and epigastric pain. Pancreatitis was confirmed with hyperamylasaemia. CT scanning of the pancreas revealed a complex pseudo-cyst and ERCP demonstrated a pancreatic duct stricture. Hydatid disease was suggested on Ultrasound scan but serological tests were negative. After ERCP the patient deteriorated with sepsis and this prompted surgery as gas was seen within the pseudocyst on repeat CT. Laparotomy was performed and a large infected cyst in the head of the pancreas was opened and the contents evacuated. Cystostomy was anastomosed to a Roux loop of jejunum to allow drainage. Medical treatment with albendazole was given and the patient made a good recovery. Hydatid cysts of the pancreas are rare and an even rarer cause of pancreatitis. Awareness of hydatid disease should be maintained even in non endemic areas as early diagnosis and treatment can avoid serious and potentially life threatening complications.