PMC5622817_01
PMC5622817_02
Ultrasound image showing a hepatic hilar multilocular cystic mass in contact with the anterior surface of the head of the pancreas
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Abdominal ultrasound showed a multilocular hepatic cystic mass projecting at the level of the heterogeneous hypo echoic liver of the duodenum and gallbladder 46mm long major axis and coming into contact with the anterior surface of the head of the pancreas (Figure 1), in addition to a hydatid cyst, the diagnosis of a cyst of the bile duct or duodenal duplication.
Abdominal angioscan: lesional compartmentalized cystic process in contact with the second duodenum, with a thickened wall making 57mm/31mm pushing back the pancreas
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This formation appeared to depend on the head of the pancreas (Figure 2, Figure 3).
Abdominal MRI: cystic mass of the hepatic hilum in intimate contact with the duodenum, pulsing gallbladder and head of the pancreas
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This formation appeared to depend on the head of the pancreas (Figure 2, Figure 3).
Whitish mass with cystic appearance of the head of the pancreas
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Exploration found a cystic mass at the expense of the pancreatic lodge pushing the duodenum backwards without invading it (Figure 4).
Puncture-emptying of the mass brings back clear liquid (rock water)
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After protection of the surgical field and the abdominal wall by fields soaked in a scolicidal solution, draining of the mass was carried out, bringing clear liquid (rock water) (Figure 5) and a sterilization of the cyst, followed Resection of the protruding dome with extraction of 3 proliferating membranes and sterilization of the cyst with hypertonic serum (Figure 6, Figure 7).
Resection of the protruding dome
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After protection of the surgical field and the abdominal wall by fields soaked in a scolicidal solution, draining of the mass was carried out, bringing clear liquid (rock water) (Figure 5) and a sterilization of the cyst, followed Resection of the protruding dome with extraction of 3 proliferating membranes and sterilization of the cyst with hypertonic serum (Figure 6, Figure 7).
Extraction of three proliferating membranes
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After protection of the surgical field and the abdominal wall by fields soaked in a scolicidal solution, draining of the mass was carried out, bringing clear liquid (rock water) (Figure 5) and a sterilization of the cyst, followed Resection of the protruding dome with extraction of 3 proliferating membranes and sterilization of the cyst with hypertonic serum (Figure 6, Figure 7).