Injection of a scolicidal solution into an echinococcal cyst that communicates with the bile ducts may be followed by caustic sclerosing cholangitis. This complication makes the practice of injecting a scolicidal solution hazardous to the patient.
Synonym: chemical cholangitis
Injection of a caustic solution into a cyst that communicates with the biliary system can result in:
(1) sclerosing cholangitis
(2) biliary stricture with obstruction
Types of scolicidal solutions:
(1) 2% formaldehyde
(2) 20% sodium chloride
(3) ethanol
(4) silver nitrate
(5) iodine
Signs of a cysto-biliary fistula:
(1) bile-staining of cyst contents
(2) elevated bilirubin on chemical analysis of cyst contents
(3) cholangiography
Serum alkaline phosphatase can be used to monitor a patient for this complication.
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