Acute pancreatitis due to pancreatic hydatid cyst: a case report and review of the literature

Hydatid disease caused by the larval stage of the Echinococcus parasite is a public health problem in endemic countries, especially in Tunisia. Hydatid disease can involve any organ. The liver is the most common organ involved and, together with the lungs, account for 90% of cases. Other involved sites (less than 10% of cases) are muscles, bones, kidneys, brain, and spleen. Pancreatic hydatid cysts are rare, accounting for less than 1% of cases [1,2]. Isolated involvement of the pancreas is unusual, and acute pancreatitis secondary caused by primary pancreatic hydatid cyst has rarely been reported (less than 2% of cases in endemic areas) [3]. To our knowledge, 8 cases have been reported in the literature [4-11]. We reviewed and summarized the findings from reported cases of hydatid acute pancreatitis as indicated in the English literature, as well as presenting the findings from our case (see Table 1). Only one article was not available [7] and was not included in Table 1.A 38-year-old man was admitted to our clinic with complaints of diffuse abdominal pain, nausea, vomiting for 7 days. The patient did not have any fever or jaundice. Moreover, he did not have any significant medical antecedents. On physical examination, vital signs were normal. Tenderness in the epigastrium was detected while examination of other systems was normal. Laboratory analyses were as follows: white blood cells were 13 000/mmc; hemoglobin was 14 g/dl; platelets were 142 000/mmc; amylase was 2100 U/l (normal value < 105); alanine aminotransferase (ALT) was 300 U/l (normal value < 40); aspartate transaminase (AST) was 120 U/l (normal value < 40); alkaline phosphatase (ALP) was 270 U/l (normal value < 290); gamma-glutamyl transpeptidase (GGT) was 130 U/l (normal value < 49); total bilirubin was 9 mg/l (normal value < 10); direct bilirubin was 3 mg/l (normal value < 8 mg/l); C-reactive protein was 20 mg/l (normal value < 5); and erythrocyte sedimentation rate was 70 mm/h. Serological tests incl