Adult ; Echinococcosis, Hepatic ; complications ; diagnosis ; surgery ; Female ; Humans ; Peritonitis, Tuberculous ; complications ; diagnosis ; surgery ; Tuberculosis, Hepatic ; complications ; diagnosis ; surgery

Echinococcal disease can develop anywhere in the human body. The liver represents its most frequent location. Hepatic hydatid cysts may rupture into the biliary tract, thorax, peritoneum, viscera, digestive tract or skin. We report a rare case with rupture of the right hepatic duct into a hydatid cyst in a woman with known hydatid disease and choledocholithiasis. The increased intra-luminal pressure in the biliary tree caused the rupture into the adjacent hydatid cyst. The creation of the fistula between the right hepatic duct and the hydatid cyst decompressed the biliary tree, decreased the bilirubin levels and offered a temporary resolution of the obstructive jaundice. Rupture of a hydatid cyst into the biliary tree usually leads to biliary colic, cholangitis and jaundice. However, in case of obstructive jaundice due to choledocholithiasis, it is possible that the cyst may rupture by other way around while offering the patient a temporary relief from his symptoms.
Bilirubin/blood ; Cholangiopancreatography, Magnetic Resonance ; Cholecystectomy ; Choledocholithiasis/complications/diagnosis ; Common Bile Duct/surgery ; Echinococcosis, Hepatic/complications/*diagnosis/surgery ; Female ; Gallstones/complications/diagnosis ; Hepatic Duct, Common/*surgery ; Humans ; Jaundice, Obstructive/complications/diagnosis ; Middle Aged ; Rupture ; Tomography, X-Ray Computed

Pelvic masses, especially hydatid disease, rarely present with sciatica (1, 2). We present the computed tomography (CT) and the magnetic resonance imaging (MRI) findings of a 49-year-old female patient with presacral hydatid disease, who was evaluated for her sciatica. We also want to emphasize the importance of assessing the pelvis of patients with symptoms and clinical findings that are inconsistent and that cannot be satisfactorily explained by the spinal imaging findings.
Animals ; Anthelmintics/administration & dosage ; Contrast Media/administration & dosage ; Diagnosis, Differential ; Echinococcosis/complications/*diagnosis/surgery ; Echinococcus/drug effects ; Female ; Humans ; Lumbosacral Plexus/parasitology/pathology/radiography ; Magnetic Resonance Imaging/*methods ; Mebendazole/administration & dosage ; Middle Aged ; Pain/etiology ; Pelvis/*pathology/*radiography/surgery ; Radiographic Image Enhancement/methods ; Recurrence ; Sciatica/*parasitology/surgery ; Tomography, X-Ray Computed/*methods