ACUTE PANCREATITIS AS A RARE COMPLICATION OF RUPTURE OF HYDATID LIVER CYST

Aims The purpose of our work is to show the interest and outcomes of the management of liver hydatid cyst complicated with acute pancreatitis.

Methods It is a retrospective series including 16 patients admitted for hydatid cyst of liver with acute pancreatitis at the department of hepato gastroenterology between January 2013 and July 2018.

Results The average age of our patients was 44.33 years [20; 66] with a female predominance. Only 12.5% (n = 2) of the patients had past history of surgical cure of liver hydatid cyst. All patients had acute pancreatitis associated with cholangitis. Abdominal CT scan showed edematous pancreatitis in 87.5% (n = 14) and the necrotizing pancreatitis in 12.5% (n = 2). The common bile duct (CBD) was dilated in all patients and the kystobiliary fistula was identified in 68.75% (n = 11). ERCP was performed for all our patients, cholangiography showed filling defect in distal CBD and a communication between intra-hepatic biliary duct with the hydatid cyst. Sphincterotomy was performed with evacuation of membranes in 87,5%.

Conclusions Acute pancreatitis is an exceptional complication of hydatic liver cyst. It is often associated with cholangitis. The ERCP combined to surgery remain the key of the treatment.