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A 28 year female presented with dull pain in the upper abdomen for 1 year and distension/ fullness in abdomen and itching all over the body for 1 month. Examination showed icterus and a palpable gall bladder. Serum bilirubin was 4 mg/DL, serum alkaline phosphatase was 700 IU/L, Alanine transaminase was 103 IU/L and Aspartate transaminase was 201 IU/L. Magnetic Resonance Cholangio-Pancreaticography (MRCP) showed a thick walled cystic lesion with some solid component, measuring 8 X 7 X 6.1 cm at lower end of Common Bile Duct, with internal membranes and calcifications (Figure 1). Common Bile Duct (23mm), Common Hepatic Duct (13mm) and Intra Hepatic Biliary Radicals were dilated. Gall bladder showed multiple calculi. A provisional diagnosis of Hydatid cyst of head of pancreas was made. Hydatic serology was not done due to its non-availability. Patient was given 400 mg of Albendazole, once a day for 3 weeks and then was taken up for surgery.

Primary hydatid cyst of head of pancreas communicating with common bile duct containing stones