Intrabiliary rupture of liver hydatid cyst: a case report and review of the literature

Abstract

Herein, we report a 66 year old woman who was diagnosed to have intrabiliary rupture of liver hydatid cyst with demonstrative computed tomography, magnetic resonance imaging, and magnetic resonance cholangiopancreatography findings, with a review of the literature.

Cysto-biliary communication in liver hydatidosis

“…Some authors state that up to 90% of the liver hydatid cyst in its evolution had some kind of communication [5,10,17,31]. This variation in incidence is due to the absence of an internationally accepted definition [18,23,27].…”

“…When frank intrabiliary rupture is greater than 5 mm, cyst content is seen on bile duct in 65% of patients, but if it is smaller than 5 mm, it is exceptional to find cystic material on the bile duct (22.35). There are other classifications of the communication between the cyst and the biliary tree; Lewall et al distinguished three clinical forms of communications: contained rupture, communicating, and frank intrabiliary rupture [10,35,36]. Cysto-biliary communications have also been classified depending on the location in tangential (side to side) or terminal (end to side), or according to the caliber of the affected BD: small or large caliber (sectorial, right or left duct) and by size (smaller or larger than 5 mm) (31.35).…”

“…There are several classifications of the communication between the cyst and the biliary tree. The most accepted divides communication according to their size: smaller communication is called simple communication (10-37% of patients with liver hydatid cyst), which is a small communication between the cyst wall and small biliary radicals; some authors subdivided these breaks into honest (bile within the cyst), insidious (after opening no bile in the cyst) [2,10,12,17,19,23,27,33], or frank intrabiliary rupture (3-17% of patients with liver hydatid cyst). Frank intrabiliary rupture is an open wide communication between the cyst and the bile duct allowing the contents of the cyst to drain directly into the bile duct and could cause obstructive jaundice, cholangitis, cyst infection, or anaphylaxis [2, 7, 10-12, 15-20, 23-25, 34].…”

“…Hepatic hydatidosis is a zoonotic disease endemic in certain areas of the planet caused by the larvae of the genus Echinococcus [1][2][3][4][5][6][7][8][9][10][11][12][13]. The two most important are Echinococcus granulosus that causes cystic echinococcosis and Echinococcus multilocularis that produces alveolar echinococcosis [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

“…The two most important are Echinococcus granulosus that causes cystic echinococcosis and Echinococcus multilocularis that produces alveolar echinococcosis [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Among the severe complications of liver hydatid cysts caused by E. granulosus, the most frequent is rupture or communication between the cyst and the biliary tree (CBC) [3-13, 15, 16].…”