Endoscopic management of intrabiliary-ruptured hepatic hydatid cyst.
OBJECTIVE
Intrabiliary rupture of hepatic hydatid cyst causes serious morbidity and mortality. These patients are usually managed surgically. We evaluated the feasibility and outcome of an alternative method of treatment of these patients.


METHODS
Seven patients with ruptured hepatic hydatid into the biliary tract underwent endoscopic treatment consisting of endoscopic sphincterotomy, cyst material extraction and hypertonic saline lavage via nasocystic catheter.


RESULTS
Median age of patients was 40 years (range 17-50 years) with a male:female ratio of 2:5. Abdominal pain, jaundice and fever were seen in all patients. Six out of seven patients were positive for hydatid serology. All patients were successfully treated by endoscopic sphincterotomy, clearance of cyst material and hypertonic saline lavage. On a follow-up of 6 months to 4 years (median, 3.5 years), ultrasonography, computed tomography of the abdomen and magnetic resonance imaging of the abdomen showed a complete cure. There were no complications related to procedure.


CONCLUSIONS
This study demonstrates endoscopic treatment as one of the therapeutic options of ruptured hepatic hydatid cyst into the biliary tract.
Singh
Virendra
V
Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. virendrasingh100@hotmail.com
Reddy
Deevaguntla Chandrasekhar
DC
Verma
Ganga Ram
GR
Singh
Gurpreet
G
D000293:Adolescent; D000328:Adult; D001659:Biliary Tract / Q000000981:diagnostic imaging / Q000469:parasitology; D002758:Cholangiography; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012421:Rupture; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D016896:Treatment Outcome