Aday Ulas, Kayaalp Cuneyt, Kapan Murat
Diyarbakir Egitim Arastirma Hospital, Department of Surgery, Diyarbakir, Turkey.
Inonu University, Liver Transplantation Institute, Malatya, Turkey.
Caspian J Intern Med. 2017 Winter;8(1):49-51.
Rupture into the biliary ducts is the most frequent complication of hydatid liver disease. In endemic areas of development of jaundice in a patient with liver cyst is initially suspected to have hydatid cyst.
A 48 year-old woman with history of asymptomatic hydatid liver cysts was admitted to the emergency department with right upper quadrant abdominal pain, increased levels of liver enzymes, bilirubin and alkaline phosphatase and the initial clinical diagnosis was the hydatid cyst rupture into the bile ducts. Surgery was planned but radiological evaluation (MRI) revealed non-dilated intra-extra biliary ducts. High suspicion of hydatid rupture required diagnostic ERCP that was normal and surgery was cancelled then. A possible diagnosis of coexistent hepatitis was suspected. Liver function tests normalized gradually and no cyst rupture was determined during surgery.
These findings suggest considering the possible development of cryptogenic hepatitis in patients with preexisting hydatid cyst.
破入胆管是肝包虫病最常见的并发症。在流行地区，肝囊肿患者出现黄疸最初怀疑患有包虫囊肿。
一名48岁有无症状肝包虫囊肿病史的女性因右上腹疼痛、肝酶、胆红素和碱性磷酸酶水平升高入住急诊科，初步临床诊断为包虫囊肿破入胆管。计划进行手术，但影像学评估（MRI）显示肝内外胆管未扩张。高度怀疑包虫破裂需要进行诊断性ERCP，结果正常，随后取消了手术。怀疑可能并存肝炎。肝功能检查逐渐恢复正常，手术中未发现囊肿破裂。
这些发现提示对于已有包虫囊肿的患者应考虑隐匿性肝炎的可能发展。
