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ERCP for Acute Severe Hydatic Cholangtis
Case description
A 72-year-old patient presented with severe acute cholangitis associated with a hepatic hydatic cyst, following unsuccessful surgical treatment. The patient also exhibited acute renal failure and abnormal liver function tests. A CT scan revealed a 12 mm common bile duct (CBD) and suspected hydatid material within the CBD.
During ERCP, the CBD was accessed with ease. Contrast injection revealed defects in the CBD. After performing a sphincterotomy, balloon sweeping was attempted but yielded no significant results. A guidewire was advanced into the right biliary duct, allowing access to the cyst. Over the course of more than 40 minutes, the cyst membrane and a substantial amount of pus were successfully extracted. A large balloon dilation of the sphincter was performed to facilitate thorough washing of the cyst.
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