Case Report

Primary Localization of a Hydatid Cyst in the Pancreas via Laparoscopic Treatment: A Case Report

Abstract

Hydatid disease is mainly because of the Echinococcus granulosus at the larval stage. The liver and lung are its most consequences. The pancreatic hydatid cyst (PHC) incidence is very low (0.14%-2%). A 55-year-old female patient presented with epigastric pain for the last one year that the pain did not continue but during one months ago suffered continually. In physical examination, there was not any abdominal bulb, tenderness and rebound tenderness. A 54×59 mm cystic structure was observed by ultrasonography (USG) and Contrast-enhanced Computed Tomography (CT) in the pancreatic body with stone in the gallbladder. Amylase, lipase, and LFT levels were normal. The Anti-hydatid antibody was positive. During laparoscopic exploration, a hydatid cyst was found. Partial cystectomy with external drainage and cholecystectomy was performed once irrigation with scolicidal agent and evacuation of cystic contents was conducted. Histopathological biopsy reported Hydatid cyst. A pancreatic, hepatic cyst is a rare event. Hematogenous is the most common spread way. Cysts in the pancreatic head could be found with obstructive jaundice. Usually, cysts in the body and tail are known to be asymptomatic. USG, CT, and Hydatid serology are useful with the clinical diagnosis as well as monitoring the recurrence. An exploration via surgery is an option that includes pericystectomy, partial cystectomy with/without external drainage or omentopexy, marsupialization, or cysto-enterostomy, which is done. What makes this case unique is the laparoscopic method that we used instead of open surgery, which is a treatment of choice. The recommendation is pre-operative and postoperative antihelminthic (Albendazole). PHC could be present as pseudocyst or cystic neoplasm of the pancreas. For patients with endemic regions and laparoscopic surgery, differential diagnosis of the cystic pancreatic lesion should be noticed. Common surgery approach could be considered for such patients.

1. Bhagani S, Cropley I. The Liver in Infections. In: Dooley JS, Lok AS, Garcia‐Tsao G, Pinzani M, eds. Sherlock's Diseases of the Liver and Biliary System. 13th ed. USA: John Wiley & Sons, 2019.
2. Ashfaq H, Obaid O, Shafi S, Ul Hassan M, Rather A. Hydatid disease of liver and disseminated hydatidosis: anatomical, microbiological and radiological perspective. Int J Res Med Sci 2013;1:101-3.
3. Ahmed Z, Chhabra S, Massey A, Vij V, Yadav R, Bugalia R, et al. Primary hydatid cyst of pancreas: Case report and review of literature. Int J Surg Case Rep 2016;27:74-7.
4. Shah OJ, Robbani I, Zargar SA, Yattoo GN, Shah P, Ali S, et al. Hydatid cyst of the pancreas. An experience with six cases. JOP 2010;11:575-81.
5. Akbulut S, Yavuz R, Sogutcu N, Kaya B, Hatipoglu S, Senol A, et al. Hydatid cyst of the pancreas: report of an undiagnosed case of pancreatic hydatid cyst and brief literature review. World J Gastrointest Surg 2014;6:190-200.
6. Mandelia A, Wahal A, Solanki S, Srinivas M, Bhatnagar V. Pancreatic hydatid cyst masquerading as a choledochalcyst, J Pediatr Surg 2012;47:e41-4.
7. Turkyilmaz Z, Kapisiz A, K Sonmez K, Karabulut R, Basaklar AC. Obstructive jaundice resulted from hydatid cyst of pancreatic head. Hippokratia 2013;17:378-9.
8. Szanto P, Goian L, Al Hajjar N, Badea R, Seicean A, MD, Manciula D, et al. Hydatid cyst of the pancreas causing portal hypertension. Maedica (Buchar) 2010;5:139-41.
9. Chinya A, Khanolkar A, Kumar J, Sinha SHK. Isolated hydatid cyst of the pancreas masquerading aspancreatic pseudocyst. BMJ Case Rep 2015;2015:bcr2015211307.
10. Sharma S, Sarin H, Guleria M, Agrawal K. Endoscopic ultrasound-guided FNA: emerging technique to diagnose hydatid cyst of pancreas. J Cytol 2015;32:211-2.
11. Lewall DB, McCorkell SJ. Hepatic echinococcal cysts: sonographic appearance and classification. Radiology 1985;155:773-5.
12. Masoodi MI, Nabi G, Kumar R, Lone MA, Khan BA, Naseer Al Sayari K. Hydatid cyst of the pancreas: a case report and brief review. Turk J Gastroenterol 2011;22:430-2.
13. Agrawal S, Parag P. Hydatid cyst of head of pancreas mimicking choledochal cyst. BMJ Case Rep 2011;2011:bcr0420114087.
14. Sbihi Y, Rmiqui A, Rodriguez-Cabezas MN, Orduña A, Rodriguez-Torres A, Osuna A. Comparative sensitivity of six serological tests and diagnostic value of ELISA using purified antigen in hydatidosis. J Clin Lab Anal. 2001;15:14-8.
15. Sayek I, Onat D. Diagnosis and treatment of uncomplicated hydatid cyst of the liver. World J Surg. 2001;25:21-7.
16. Varshney M, Shahid M, Maheshwari V, Mohammed Azfar Siddiqui, Siddiqui MA, Alam K, Mubeen A, et al. Hydatid cyst in tail of pancreas. BMJ Case Rep. 2011;2011:bcr0320114027.
17. Karaman B, Battal B, Ustunsoz B, Ugurel MS. Percutaneous treatment of a primary pancreatic hydatid cyst using a catheterization technique. Korean J Radiol 2012;13:232-6.
18. Motie MR, Rezapanah A, Pezeshki Rad M, Razavian H, Azadmand A, Khajeh M. Primary Localization of a Hydatid Cyst in the Latissimus Dorsi Muscle: An Unusual Location. Surg Infect (Larchmt) 2011;12:401-3.
19. Besim H, Karayalçin K, Hamamci O, Güngör C, Korkmaz A. Scolicidal agents in hydatid cyst surgery. HPB Surg 1998;10:347-51.
Files
IssueVol 59, No 4 (2021) QRcode
SectionCase Report(s)
Published2021-05-18
DOI https://doi.org/10.18502/acta.v59i4.6223
Keywords
Hydatid cyst Pancreatic cyst Laparoscopy

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Hashemi Fard A, Hoseinpour Deyrestani H, Golmohamadi H, Rezapanah A. Primary Localization of a Hydatid Cyst in the Pancreas via Laparoscopic Treatment: A Case Report. Acta Med Iran. 59(4):232-235.