Intrabiliaryrupture of hydatid cyst in a patient with cirrhosis

  Abstract   Acase of 48-year-old male, hepatitis B cirrhosis , hepatic hydatid cyst, jaundice,   fever, chills suffered from severe abdominal pain in the right upper quadrant. He was   suffered from acute cholangitis and spontaneous bacterial peritonitis, and received   intravenous antibiotics but his condition rapidly deteriorated to sepsis and severe hepatic   failure. The presence of dilated Common Bile Duct (CBD) containing small   cystic lesions suggesting daughter cysts on ultrasonography, which was further verified   by Endoscopic Retrograde Cholangiopancreatography (ERCP), along with significant   eosinophilia and positive serology test for hydatid cyst, made the diagnosis   of intrabiliary rupture of hydatid cyst definite. We performed a delayed endoscopic   sphincterotomy which resulted in complete resolution of the clinical picture. The patient   was treated with Albendazol and Lamivudin and was referred for surgery.