AN UNUSUAL CYSTIC PANCREATIC MASS

Hydatidosis is an endemicdisease in Morocco. Localization in the pancreas is very rare especially when isolated. We report the case of a patient admitted in the emergency room for a suppurated pancreatic collection, about 15 cm in diameter, resembling a fistulized Pseudo-pancreatic cyst, or a cystic pancreatic tumoror a pancreatic hydatid cyst. In spite of an initial empirical antibiotic therapy, the unfavorable evolution led us to perform an exploratory laparotomy which confirmed the diagnosis of an isolated pancreatic hydatid cyst. The classic surgical treatment by subcutaneous laparotomy is still effective in this situation, and consists of cyst drainage and a cysto-jejunal bypass on a Y loop to compensate for the pancreatic cyst-channel fistula. Because of the emergency context, large volume, lack of diagnosis certainty and the slow evolution of this cyst, we preferred surgical treatment to per cutaneous or endoscopic drainage.