An unusual appearance of complicated hydatid cyst: necrotizing pancreatitis.

Hydatid acute pancreatitis is a rare condition and always presents as consequence of acute edematous pancreatitis. Intrabiliary rupture of hepatic hydatid cysts and obstruction of papillary orifice with hydatid membrane is possible mechanism. A 49-year-old man was admitted with epigastric and right upper quadrant pain, nausea, and vomiting. Computed tomography scan showed 5 x 5 cm cyst in left hepatic lobe, which had ruptured into the biliary tract and caused necrotizing pancreatitis. Endoscopic retrograde cholangiopancreatography trial failed. Surgical choice was drainage of cyst, insertion of T-Tube, exploration of common bile duct and omentoplasty. No additional necessary surgical intervention was necessary for necrotizing pancreatitis. Clinical and laboratory findings resolved rapidly and there was no recurrent pancreatitis episode during 1 year of follow-up. Hydatid edematous and necrotizing pancreatitis have similar progress. Recovery is quick and uneventful after elimination of mechanical obstruction of papillary orifice.