Saad Charbel, Mortada Shaza, Dakroub Ali, Ghaida Makram Abou, Hage Lory, Zahreddine Radwan, Slim Abdallah, Chemaly Rodrigue, Hajj Georges Al
Department of Surgery, Division of General Surgery, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon.
Department of Internal Medicine, Division of Gastroenterology, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon.
Case Rep Gastrointest Med. 2025 Aug 8;2025:1244948. doi: 10.1155/crgm/1244948. eCollection 2025.
Cystic echinococcosis is a common cystic infection in endemic areas. Solitary lesions are commonly found in the liver and are primarily caused by . Other organs can be involved as well but to a lesser degree. This paper presents a rare manifestation of a hydatid liver cyst causing acute pancreatitis. A 67-year-old female presented with right upper quadrant pain, nausea, and vomiting. She was found to have a large hepatic cystic echinococcosis occupying the right lobe of the liver with associated acute pancreatitis. After endoscopic retrograde cholangiopancreatography (ERCP), three small yellow membrane fragments-presumed to be daughter cyst membranes-were found obstructing the common bile duct at the ampulla of Vater. The patient underwent laparoscopic unroofing of the hepatic cystic echinococcosis and laparoscopic cholecystectomy with an uneventful postoperative course. Treatment modalities for hepatic cystic echinococcosis depend on the size of the cyst, imaging findings, cyst activity status, and associated complications. In nonendemic countries, where demographic changes occur due to travel from endemic regions, a high index of suspicion is necessary for timely diagnosis. A laparoscopic approach was chosen for its benefits related to minimally invasive surgery. While laparoscopic management of hepatic cystic echinococcosis is well described, its use in cases complicated by acute pancreatitis remains infrequently reported. Cystic echinococcosis most commonly presents in the liver. When associated with acute pancreatitis, a combined approach involving albendazole, ERCP, and sphincterotomy is typically required, with surgical resection depending on cyst classification.
囊性棘球蚴病是流行地区常见的囊性感染。孤立性病变常见于肝脏,主要由……引起。其他器官也可能受累,但程度较轻。本文介绍了肝包虫囊肿导致急性胰腺炎的一种罕见表现。一名67岁女性出现右上腹疼痛、恶心和呕吐。她被发现患有一个巨大的肝囊性棘球蚴病,占据肝脏右叶,并伴有急性胰腺炎。在内镜逆行胰胆管造影(ERCP)后,发现三个小黄膜碎片——推测为子囊膜——在Vater壶腹处阻塞胆总管。患者接受了肝囊性棘球蚴病的腹腔镜去顶术和腹腔镜胆囊切除术,术后过程顺利。肝囊性棘球蚴病的治疗方式取决于囊肿大小、影像学表现、囊肿活动状态及相关并发症。在非流行国家,由于来自流行地区的人员流动导致人口结构变化,因此需要高度怀疑以进行及时诊断。选择腹腔镜手术是因其与微创手术相关的益处。虽然肝囊性棘球蚴病的腹腔镜治疗已有详细描述,但其在并发急性胰腺炎病例中的应用报道仍较少。囊性棘球蚴病最常见于肝脏。当与急性胰腺炎相关时,通常需要联合使用阿苯达唑、ERCP和括约肌切开术,手术切除则取决于囊肿分类。
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