Last update:
01-Apr-2009

This is a retrospective study to evaluate the role of computerised tomography (CT) in the preoperative diagnosis of echinococcal cyst rupture into the biliary tract and the surgical management of this complication. Eight patients were studied, who were admitted to the outpatient department with clinical symptoms, followed by laboratory confirmation of cholangitis. Abdominal CT was performed in all patients, who were then operated upon, and the intraoperative findings confirmed the preoperative CT diagnosis. Partial cystectomy, cholecystectomy, intraoperative cholangiography, common bile duct exploration and insertion of T-tube drainage were performed in all patients Seven patients had rupture of the hydatid cyst into the intrahepatic bile ducts, one of whom had a simultaneous rupture into the subcapsular hepatic space. The other patient presented with rupture of the hydatid cyst into the gallbladder. In conclusion, the ideal treatment for intrabiliary rupture of hydatid hepatic cyst should conclude with exploration of the common bile duct, using intraoperative cholangiography. If the biliary tract is cleared of all cystic content, t-tube drainage should be sufficient. CT presents a valuable imaging method for quick and accurate diagnosis of intrahepatic biliary tract and gallbladder echinococcal cyst rupture. It contributes in a highly effective manner to the preoperative evaluation and optimally timed operative treatment of these patients.

Key words: Computerised tomography, Hydatid cyst, Intrabiliary rupture.