Medical Journal of The Islamic Republic of Iran (MJIRI)

  Abstract

  Acase of 48-year-old male, hepatitis B cirrhosis , hepatic hydatid cyst, jaundice,

  fever, chills suffered from severe abdominal pain in the right upper quadrant. He was

  suffered from acute cholangitis and spontaneous bacterial peritonitis, and received

  intravenous antibiotics but his condition rapidly deteriorated to sepsis and severe hepatic

  failure. The presence of dilated Common Bile Duct (CBD) containing small

  cystic lesions suggesting daughter cysts on ultrasonography, which was further verified

  by Endoscopic Retrograde Cholangiopancreatography (ERCP), along with significant

  eosinophilia and positive serology test for hydatid cyst, made the diagnosis

  of intrabiliary rupture of hydatid cyst definite. We performed a delayed endoscopic

  sphincterotomy which resulted in complete resolution of the clinical picture. The patient

  was treated with Albendazol and Lamivudin and was referred for surgery.