Fistulous communication between hepatic hydatid cyst and stomach

Objectives: Hydatid disease primarily affecting the liver, demonstrates characteristic imaging findings but findings of unusual anatomic locations are less frequently described in the literature. We present a very rare presentation of hydatid disease.Case report: A 42-year-old woman was admitted to Al-Zahra Hospital in Isfahan complaining of abdominal pain, fever and jaundice. Ultrasonography showed a hepatic cyst and dilated intrahepatic ducts and common bile duct. CT scan confirmed a fistula between cyst and stomach. Surgery was performed and pathology confirmed cystogastric fistula. The patient had no problems in a 6-months follow-up period.Conclusions: Spontaneous rupture of a hydatid cyst into hollow viscera is an extremely rare complication. Typically, the fistula is not discovered until surgery, although in some patients it is found at radiology. Furthermore, frank rupture into the biliary tree occurs in 5-15% of cases. Familiarity with atypical manifestations of hydatid disease may be helpful in making accurate diagnosis and treatment.