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ANALYSIS OF SURGICAL MANAGEMENT OF OBSTRUCTIVE JAUNDICE DUE TO SPONTANEOUS INTRABILIARY RUPTURE OF HYDATID CYSTS OF THE LIVER

Dr Zainab Nadeem, Dr Amna Waleed, Dr Navaira Hye

A myriad of complications of hydatid cyst of liver may occur. The complications may include rupture, infection, or anaphylaxis. Rupture of hydatid cyst of liver is the most common complication. Liver hydatid can rupture in any part of biliary system but the communication with the hepatic bile ducts is most common. The basic aim of the study is to analyze the surgical management of obstructive jaundice due to spontaneous intrabiliary rupture of hydatid cysts of the liver. This case study was conducted at Shifa International Hospital, Islamabad during 2018. This was basically a case study. A 60-year-old female presented with abdominal pain and jaundice of 15 days duration. After 10 days she had fever with chills and high colored urine. General physical examination revealed yellowish discoloration of sclera. Systemic examination was normal. Abdominal examination revealed tenderness in right hypochondrium and epigastrium. Liver function test parameters were bilirubin of 9.87 mg/dl, AST 53 U/L, and ALP 410 U/L. Histopathology of gallbladder revealed features of acalculous cholecystitis. She was discharged with Albendazole therapy. Follow-up was uneventful. It is concluded that concomitant intrabiliary rupture in hepatic duct and gallbladder is rare to see. ERCP is useful in diagnosis. Surgery can give final diagnosis. However surgery is associated with many post-operative complications including persistent post-operative biliary drainage, infection of residual cavity, sinus formation, recurrence or dissemination. Key words: ERCP, Formation, Cyst, Hydatid.

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