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Hepatic hydatid cyst with acute pancreatitis

Case contributed by Mohamed Saber
Diagnosis certain

Presentation

Acute severe epigastric pain

Patient Data

Age: 40 years
Gender: Male

CT study shows the following:

  • left hepatic lobe sizable exophytic multicystic lesion is seen involving the epigastric region, encroaching upon hepatic hilum and abutting the undersurface of the diaphragm & the lesser gastric curvature. It elicits multiple variable-sized peripherally arranged cysts separated with thin septae consistent with a hydatid cyst. It measures about 12x15x12 cm
  • peripancreatic fat blurring with associated mild thickening of left anterior perirenal fascia consistent with acute pancreatitis
  • mild Splenomegally (15cm). No splenic focal lesions
  • few small para-aortic lymph nodes

Case Discussion

The patient presented acutely with severe epigastric pain. Serum lipase was high. Hepatic cystectomy was done later that confirmed hydatid ( Echinococcal) cyst of the liver

Acute pancreatitis secondary to a hepatic hydatid cyst occasionally occurs, caused by communication of the cyst to the biliary system with subsequent irritation and inflammation 1

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