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An extremely rare presentation of hydatid cyst disease: hepatic artery pseudoaneurysm bleeding and synchronous duodenal fistula

Cilt: 47 Sayı: 4 28 Aralık 2022
İdris Kurt *, Nazlıcan Cengiz , Neslican Demir , Ali Rıza Soylu , Osman Kula
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Cukurova Medical Journal Kapak Cukurova Medical Journal
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An extremely rare presentation of hydatid cyst disease: hepatic artery pseudoaneurysm bleeding and synchronous duodenal fistula

Abstract

Aims: Hydatid cyst disease is a rare cause of upper gastrointestinal bleeding. Peculiarly if it's resulted from a ruptured hepatic artery aneurysm in the hydatid cyst cavity which is fistulated into the duodenum. We here present a case of hepatic artery pseudoaneurysm due to a complicated hydatid cyst with synchronous duodenal fistula. Case: A 45-year-old male was admitted to the emergency department with hematemesis and hematochezia. The patient had a history of a hydatid cyst of liver and a surgical procedure of lung ecinoccosis. Endoscopy revealed an unusual ulcerated lesion in the duodenum. Yellow membranes were observed in the midst and blood oozing. After unsuccessful endoscopic sclerotherapy, a Computerized Tomography (CT) was performed. CT revealed a ruptured hydatid cyst into the duodenum and bleeding from the formed hepatic artery pseudoaneurysm. Hepatic artery coil embolization was performed urgently and a percutaneous transhepatic drainage catheter was applied to maintain the bile flow. Subsequently, a 10 Fr , 10 cm plastic stent was inserted via Endoscopic Retrograde Cholangiopancreatography (ERCP). The rare complication which was observed after embolization was the hepatic abscess. Although a percutaneous catheter was inserted initially, drainage wasn’t successful. As a last option, surgical debridement was considered. Conclusion: If a patient who presented with upper gastrointestinal bleeding with a previous history of liver hydatid cyst, cyst complications must be listed as a differential diagnosis. Besides endoscopy, contrast-enhanced CT and ЕRCP are the essential diagnostic and therapeutic approaches.

Keywords

coil embolisation , duodenal fistula , echinococcosis , hepatic artery pseudoaneurism , hydatid cyst , upper gastrointestinal bleeding

Kaynakça

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Ayrıntılar

Birincil Dil

İngilizce

Konular

Klinik Tıp Bilimleri

Bölüm

Editöre Mektup

Yazarlar

Yayımlanma Tarihi

28 Aralık 2022

Gönderilme Tarihi

15 Ekim 2022

Kabul Tarihi

5 Aralık 2022

Yayımlandığı Sayı

Yıl 2022 Cilt: 47 Sayı: 4

DOI

https://doi.org/10.17826/cumj.1186393

IZ

https://izlik.org/JA42MB68JF

Kaynak Göster

RIS / Bibtex
MLA
Kurt, İdris, vd. “An extremely rare presentation of hydatid cyst disease: hepatic artery pseudoaneurysm bleeding and synchronous duodenal fistula”. Cukurova Medical Journal, c. 47, sy 4, Aralık 2022, ss. 1776-9, doi:10.17826/cumj.1186393.
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