OBSTRUCTIVE JAUNDICE ZOONOTIC CAUSE

Obstructive jaundice is caused by blockade of common bile duct due to various etiologies. It commonly manifest as right hypocondrial pain, fever and jaundice. We had an interesting patient of Hydatid cyst of liver who presented with history of obstructive jaundice. Abdominal imaging was suggestive of obstructed biliary system but it didnt establish the cysto biliary communication. In view of cholangitis, we did ERCP (endoscopic retrograde cholangiopancreatography) and cholangiogram for that patient. It established the communication of cyst cavity to the right biliary system and daughter cyst was found in common bile duct which causing obstructive jaundice. We put a plastic stent in the right system to decompress the biliary system and referred the patient to surgical gastroenterology department for surgical management. Hence ERCP is an important tool in establishing the cysto biliary communication even other imaging modality such as MRCP fails. Any patient with hydatid cyst with elevated bilirubin and alkaline phosphatase should be undergone ERCP to rule out cysto biliary communication.