A 67-year-old woman had been followed since 2011 for a type V hydatid cyst of the liver (segment VII), completely calcified and considered inactive (Figure 1). In March 2025, she underwent laparoscopic cholecystectomy for acute calculous cholecystitis, without intervention on the cyst. Five months later, she presented with acute cholangitis. Abdominal CT revealed a 7-cm cyst with loss of its calcified wall and a cysto-biliary fistula (Figure 2), associated with intra- and extrahepatic bile duct dilatation.
Ismail et al. (Sun,) studied this question.