LAUSR

© BMJ Publishing Group Limited 2022. No commercial reuse. See rights and permissions. Published by BMJ. DESCRIPTION Zoonotic infections like cystic echinococcosis are significant health concerns in developing countries. Humans are the intermediate hosts and acquire the infection by accidentally ingesting dog faeces. Hydatid cyst is usually asymptomatic or can be an incidental finding during radiological workup, the liver being the most common organ to be involved. There may be slight abdominal discomfort or pain due to compression of the adjacent organs until they rupture. Although hydatid cyst is a common entity, rupture or fistula is an uncommon complication. Rupture of this silent cyst is the primary concern that may be of two types: internal rupture occurs within the biliary tract, into the peritoneal cavity or in the gastrointestinal. In contrast, external rupture leads to a cutaneous fistula. 3 Following rupture of a hepatic cyst, a fistulous tract is observed to form with the duodenum or the colon (hepatic flexure).