title: Percutaneous alcohol sclerotherapy of a hepatic hydatid cyst after balloon occlusion of a large biliary communication.
abstract: OBJECTIVE
  To present a case of hepatic hydatid cyst with a biliary communication that was not suitable for surgery and hence necessitated sclerotherapy with absolute alcohol after occluding the biliary communication with a balloon catheter.
  
  
  METHODS
  A 50-year-old Asian man presented to the surgical emergency department with a 1-year history of repeated attacks of obstructive jaundice and right hypochondrial pain. Ultrasound and contrast computed tomography revealed a cyst, and endoscopic retrograde cholangiopancreatography and cystography revealed a biliocystic communication. An indirect hemagglutination test for echinococcosis showed the presence of antibodies to Echinococcus species at a titer of 8 establishing the diagnosis of hydatid cyst. Although surgery is the accepted modality of treatment in these cases, the patient was deemed unfit for surgery due to his underlying cardiac problem. While percutaneous treatment with absolute alcohol is contraindicated in his case, it was successfully attempted after balloon occlusion of the biliocystic communication.
  
  
  CONCLUSIONS
  This case showed that in this patient with hepatic hydatid disease and biliocystic communication, who was not fit for surgery, percutaneous sclerotherapy with absolute alcohol after balloon occlusion was successfully performed by an interventional radiologist.
authors.affiliation: Department of Clinical Radiology, Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait. jozsefvarro@gmail.com
authors.forename: Jozsef
authors.initials: J
authors.lastname: Varro
authors.forename: Laji
authors.initials: L
authors.lastname: Mathew
authors.forename: Reji Philip
authors.initials: RP
authors.lastname: Athyal
authors.forename: Abdulrahman H
authors.initials: AH
authors.lastname: Khafagy
mesh_terms: D021721:Balloon Occlusion / Q000295:instrumentation / Q000379:methods*; D001660:Biliary Tract Diseases / Q000473:pathology / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004444:Echinococcosis, Hepatic / Q000628:therapy*; D000431:Ethanol / Q000627:therapeutic use*; D006801:Humans; D041781:Jaundice, Obstructive; D008297:Male; D008875:Middle Aged; D015911:Sclerotherapy / Q000295:instrumentation / Q000379:methods*; D012997:Solvents
chemical_list: D012997:Solvents; D000431:Ethanol