Liver Hydatid Cyst Complicated by Biliary and Colonic Fistula Diagnosed after Intra-Operative Cholangiography

Background: Hydatid disease is a worldwide zoonosis and is localized in the liver in most cases. Biliary rupture and infection are the most common complications of hydatid liver. Simultaneous biliary and colonic fistula is uncommon. Clinical diagnoses is difficult, however, ultrasound echography and abdominal computed tomography (CT) scan can detect these complications. Case Presentation: Our case was diagnosed by a peri-operative trans-cystic cholangiography showing simultaneous opacification of liver hydatid cyst and the right colonic angle. The decision was to disconnect the kysto-colonic fistula and create colonic stoma on the colic defect followed by drainage of the residual cavity. The course was marked by the death of the patient after four days caused by respiratory and renal failure. Conclusion: This abnormal communication is always secondary to hydatid-cyst infection caused by hydatid cyst-biliary fistula. Surgical treatment is sometimes difficult and prognosis depends on the gastrointestinal organ affected.