Hepato-pericardial fistula revealed by a massive pericardial effusion: A case report of an exceptional complication of the hydatid liver cyst

INTRODUCTION: The rupture of the hydatid liver cyst in the pericardium is a very exceptional and serious complication that can cause sudden death following cardiac tamponade or anaphylactic shock. CASE PRESENTATION: We report a case of a 25 years-old woman with a massive pericardial effusion due to fistulization of hepatic hydatid cyst. Surgical closure of the fistula and the resection of the tow hydatid cysts were successful in managing this rare case. DISCUSSION: Hepato-pericardial fistula is an extremely rare complication of hydatid liver cyst. Only 6 similar cases were previously reported in the literature. The Hepato-pericardial fistula may result in an acute pericarditis that progress to either cardiac tamponade or constrictive pericarditis. Its diagnosis is based on ultrasound and CT imaging. The surgical treatment with supportive therapy seems to improve the outcomes. CONCLUSION: Pericardial effusion secondary to rupture of hepatic hydatid cyst should always be suspected in endemic countries.