Endoscopic retrograde cholangiography for intrabiliary rupture of hydatid cyst.

The most common complication of hydatid cysts of the liver is cholestasis due to rupture of hepatic cysts into the biliary tree. Such a complicated cyst is usually managed by surgical cyst resection. Endoscopic retrograde cholangiogram with sphincterotomy is a well-established method for preoperative and postoperative extraction of cyst material from the biliary tree. Successful nonsurgical treatments of complicated hydatid cyst are reported with a combination of pharmaceutical therapy and endoscopic techniques consisting of endoscopic sphincterotomy and instillation of hypertonic saline solutions. We report feasibility and outcome of the endoscopic method for treatment of ruptured hepatic hydatid cyst into the biliary tract that also benefited from drainage of the whole cyst and membranes into the major biliary duct.