Surgical management of a hydatid cyst of the hepatic dome ruptured into the biliary tree

Abstract EN

Background : Hydatid disease remains an important & challenging medical problem.

Case report : A62 year old male patient was admitted complaining of upper abdominal discomfort.

Six days earlier he suffered from acute pain in the right upper quadrant, mild systemic allergic manifestation, a fever of 38.5oC and chills.

He was managed by a new surgical approach of myoplasty of the right hemidiaphragm combined with preoperative decompression of the bile duct by an endoscopic sphincterotomy.

A case search identified study describing rupture of a hydatid cyst of the hepatic dome into biliary tract.

The incidence of intrabiliary rupture of hepatic hydatid cysts is 25 % in patients treated with external surgical drainage for liver hydatid cysts.

Postporative external biliary fistula have been reported in 27.5 %.

Conclusion : this procedure may require less time (because liver mobilization is not necessary) and allows for easier abdominal reoperation in the future.

The simplicity of the technique allows for a more reliable alternative to the treatment of the hydatid cyst located over the superior-posterior aspects of the liver.