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British Journal of Radiology 75 (2002),271-274 © 2002 The British Institute of Radiology

Case report

Intrabiliary rupture of hydatid cyst: diagnosis with MRI and hepatobiliary isotope study

R Kumar, DRM, DNB1, S N Reddy, MS, FRCS Ed2 and S Thulkar, MD3

Departments of 1 Nuclear Medicine, 2 Surgery and 3 Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India

Correspondence: Dr Rakesh Kumar, F-74, Ansari Nagar, AIIMS Campus, New Delhi 110 029, India

Intrabiliary rupture is the most common complication of hepatic hydatid cyst yet it is unusual, occurring in only 3–17% of cases. The diagnosis is rarely difficult on ultrasound and CT when typical radiological features are present. In rare cases of complete evacuation, when characteristic findings of hydatid cyst are absent or when there is no evidence of the previous existence of liver hydatid cyst, the diagnosis may be difficult. In difficult cases, MRI, MRCP, ERCP and 99Tcm-mebrofenin hepatobiliary scintigraphy are employed. We present a rare case of surgical obstructive jaundice due to rupture of a liver hydatid cyst into the biliary tract and gall bladder, with complete evacuation of its contents leading to misdiagnosis on CT and ultrasound. MRCP and 99Tcm-mebrofenin hepatobiliary scintigraphy were able to establish a firm pre-operative diagnosis.




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