ArticleJournal of medical case reports2026
Laparoscopic management of an infected hepatic hydatid cyst with cystobiliary fistula in a child: a case report.
Article in Journal of medical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHydatid disease caused by Echinococcus granulosus commonly affects the liver and remains a health burden in endemic regions. Infected hepatic hydatid cysts with occult cystobiliary communication are particularly challenging to manage in children, where evidence is scarce. This case is notable for demonstrating the feasibility and safety of laparoscopic management in such a complex pediatric presentation. CASE PRESENTATION: This report describes a case of a Yemeni 12-year-old male individual from a rural area presenting with a 5-year history of progressive right hypochondrial pain, recent anorexia, nausea, and intermittent low-grade fever. Serological testing was positive for Echinococcus granulosus. Imaging studies including ultrasound and contrast-enhanced computed tomography (CT) revealed a 7 cm infected hydatid cyst in liver segment VIII with characteristic detached internal membranes but no clear cystobiliary communication. The patient underwent laparoscopic partial pericystectomy following preoperative albendazole therapy. Intraoperatively, adhesions to the diaphragm were carefully lysed, and the cyst was drained without spillage after instillation of hypertonic saline. A minor cystobiliary fistula with active bile leakage was identified and successfully closed laparoscopically with sutures and additional clip. A drain was placed in the cyst cavity. Postoperative management included albendazole and broad-spectrum antibiotics. The patient recovered uneventfully with no bile leakage, and follow-up ultrasonography at 4 months showed no recurrence or biliary complications.
conclusionThis case highlights that laparoscopic partial pericystectomy with closure of cystobiliary fistula is a feasible, safe, and effective minimally invasive approach for infected hepatic hydatid cysts in pediatric patients. Careful surgical technique with meticulous intraoperative identification and repair of cystobiliary communications is essential to minimize postoperative morbidity, enabling rapid recovery and favorable clinical outcomes.
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