Ruptur einer Echinokokkuszyste der Leber in die Gallenwege

Intrabiliary rupture of hepatic hydatid cyst is a common complication associated with hepatic hydatid cysts. It is important to appreciate the direct and indirect signs of this condition.

Radiographic features

The radiological features of intrabiliary rupture of a hepatic hydatid cyst can be classified into direct and indirect signs which can be seen on CT, ultrasound, and MRI. However, current studies have shown increased value of MRCP in diagnosis.

Direct signs
  • direct visualization of cystobiliary communication
Indirect signs
  • break in cyst wall adjacent to a bile duct
  • biliary tree dilatation
  • cystic material within the biliary tree or gallbladder
  • distorted shape of cyst representing reduced intracystic pressure secondary to rupture
  • presence of gas-fluid or fat-fluid level within the cyst
  • displacement of bile ducts due to extrinsic pressure
  • beak-like projection of cyst wall
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