Hydatid cyst-colonic fistula: an exceptional complication

Madhuri Barabde, Pravin Bijwe, Saurabh Tiwari, Vasant Lavankar


Hydatid disease is a worldwide zoonosis and is localized in the liver in most cases. Its complications are numerous and include those related to the compression of adjacent viscera, infection of the cyst's contents or perforation of the cyst. Spontaneous rupture of the hepatic hydatid cyst into colon is an extremely rare complication. The communication is, typically, not discovered until surgery. We present a case of a liver hydatid cyst communicating with the hepatic flexure of colon. The surgical treatment of the lesion and its complications was complex but successful and included partial cystectomy with prolonged external tube drainage.


Hydatid cyst, Complications, Fistula, Colon

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Beggs I. The radiology of hydatid disease. AJR Am J Roentgenol. 1985;145(3):639-48.

Radford AJ. Hydatid Disease. In: Weatherall DJ, Leding¬ham JGG, Warell DA, eds.Oxford textbook of medicine. Oxford: Oxford University Press, 1982:5.442-5.444.

Wen H, Aji T, Shao YM. Diagnosis and management against the complications of human cystic echinococco¬ sis. Front Med China. 2010;4(4):394-8.

Marti-Bonmati L, Menor F, Ballesta A. Hydatid cyst of the liver: rupture into the biliary tree. AJR Am J Roent¬genol. 1988;150(5):1051-3.

Lewall DB, McCorkell SJ. Rupture of echinococcal cysts: diagnosis, classification, and clinical implications. AJR Am J Roentgenol. 1986;146(2):391-4.

Lo Casto A, Salerno S, Grisani M, Mastrandrea G. Hydatid cyst of the liver communicating with the left colon. Br J Radiol.1997;70:650-1.

Bougioukas IG, Courcoutsakis N, Korakianitis OS, Tentes AA, Prasopoulos P. Liver hydatid cyst perforated in to the large bowel: a case report. Cases J. 2009;2:6999.

Teke Z, Yagci AB, Atalay AO, Kabay B. Splenic hydatid cyst perforating into the colon manifesting as acute massive lower gastrointestinal bleeding: an unusual presentation of disseminated abdominal echinococcosis. Singapore Med J. 2008;49:e113-6.

Morris DL, Smith WD, Alexander-Williams J. Colohepatic fistula due to hydatid disease. World J Surg. 1983;7:797-8.

Choliz JD, Olaverri LFJ, Casas FT, Zubieta OS. Computed tomography in hepatic echinococcosis. AJR Am J Roentgenol.1982;139(4):699-702.

Marti-Bonmati L, Menor Serrano F. Complications of hepatic hydatid cysts: ultrasound, computed tomography, and magnetic resonance diagnosis. Gastrointest Radiol.1990;15(2):119-25.

Diez Valladares L, Sanchez-Pernaute A, Gonzalez O, Perez-Aguirre E, Talavera P, Olmo GA, et al. Hydatid liver cyst perforation into the digestive tract. Hepatogastroenterology. 1998;45:2110-4.

Hankins JR. Management of complicated hepatic hydatid cysts. Ann Surg. 1963;158:1020-34.

Zaouche A. Liver hydatid surgery: about 2013 case. Tunis: Tunisian Association for Surgery; 1994.

Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS. Hydatid disease: radiologic and pathologic features and complications. Radiographics. 2000;20:795-817.