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May 1989

Sclerosing Cholangitis Associated With Hydatid Liver Disease

Arch Surg. 1989;124(5):637. doi:10.1001/archsurg.1989.01410050127025

To the Editor.—In the October 1986 issue of the Archives, Belghiti et al1 referred to a case commented on but unpublished. We present a description and the final outcome of this case.

Report of a Case.—A 56-year-old woman was operated on for a hydatid liver cyst in 1978. After aspiration of a small amount of bile-stained hydatid fluid, 20 mL of 40% ethanol was injected into the cyst. The entire biliary tree was found to be filled with hydatid membranes. After the bile ducts were emptied a choledochoduodenostomy was performed because of papillary stenosis. A fistulography done two weeks after the operation because of persistent biliary drainage showed multiple strictures of the intrahepatic bile ducts. The biliary fistula closed spontaneously but several bouts of cholangitis were observed over the years. An endoscopic retrograde cholangiopancreatogram showed multiple biliary strictures compatible with sclerosing cholangitis (Figure) and a liver

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