Hydatid cyst of the head of the pancreas with spontaneous fistula to the duodenum.

Primary pancreatic hydatidosis is exceptional. Only 12 cases have been reported in Spain up to 1982. In large series of patients with hydatidosis, pancreatic involvement occurs in 0.25% of cases. We describe a 55-yr-old man who was admitted to the hospital because of fever, epigastric pain, and abdominal mass. Endoscopy, upper gastrointestinal series, and computerized tomography revealed a fistula between the duodenum and the pancreatic tumor. At surgical exploration, a primary infected hydatid cyst in the head of the pancreas communicating with the duodenum was encountered. The cyst was removed and drained. We have been unable to find in the literature a review of this form of presentation of pancreatic hydatidosis.