Abscess and bronchobiliary fistula following percutaneous hydatid cyst treatment: A case report

Abstract

Clinical course and treatment are uncomplicated in majority of hepatic hydatid cyst cases. However, in hydatid cysts involving percutaneous intervention, occult biliary fistulas can drain into the cavity due to a decrease in intracystic pressure, and the cyst can become complicated. Complicated cysts may be treated using non- invasive and minimally invasive methods. The cyst must be closely observed in terms of its size and location and the patient’s place of residence. Delayed surgical treatment of hydatid cysts with percutaneous intervention and abscess development leads to high morbidity and mortality. Ultrasonography-guided PAIR (puncture – aspiration– injection – respiration) was performed on a patient with a Gharbi type 1 hydatid cyst, 150x110 mm in size, located in the right hepatic lobe. Since the cyst was contiguous with the bile ducts, a percutaneous catheter was inserted and endoscopic retrograde cholangiopancreatography (ERCP) was performed. We report a case of hydatid cyst involving open surgical drainage following cavity infection and postoperative bronchobiliary fistula and pneumonia at follow-up. Patients developing percutaneous treatment-related cavity infection have worse hospital stays, treatment costs, disease-related morbidity and mortality than those undergoing open surgery. We think that patients developing cavity infection should be closely observed and that the surgical procedure should be performed without delay.