Intrabiliary rupture of a hydatid cyst of the liver with concomitant intraperitoneal rupture into the lesser sac.

A case is reported of a young man of Moroccan origin, admitted with fever, aerobilia and an epigastric mass. Laparotomy revealed a suppurated hydatid cyst extending from the left lobe of the liver, which had ruptured into the left hepatic duct and intraperitoneally, into the lesser sac. A left hepatic lobectomy was performed. Gas producing micro-organisms were cultured from the cyst contents whereas no viable scolices were demonstrated. Medical therapy with mebendazole was instituted postoperatively. Six months later, the patient underwent subtotal pancreaticoduodenectomy because of an obstructive, lymphoblastic non-Hodgkin lymphoma in the ampullary region. One year after the initial operation, there were no signs of recurrence of the hydatid disease.