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Hepatic Hydatid Cyst

Liver is the most common site of hydatid cyst formation. Hydatid cysts of the liver exert pressure on the surrounding parenchyma, and in approximately one-fourth of the cases, due to higher pressure in the cyst, the cysts eventually leak into small bile ducts or perforate into large ones. The most common complication of hydatid cyst of the liver is spontaneous rupture into the biliary tract with biliary obstruction being reported to occur in 5% to 17% of cases. Intrabiliary rupture occurs into the right duct in 55-60% of cases, into the left duct in 25- 30% and rarely into the confluence or gall bladder. A case of a hydatid cyst of the liver which ruptured spontaneously into the common hepatic duct resulting in jaundice and cholangitis which resolved following endoscopic papillotomy and endoscopic clearance of the membranes from the common bile duct. Obstructive jaundice occurs when cyst elements empty into the biliary tree. Rupture is most likely to occur in centrally located cyst with a high intracystic pressure up to 80 cm H2O. According to Lewall and McCorkell the cyst rupture can occur in three clinical forms: contained, communicating and direct.
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