A 69 yr old man with intrabiliary rupture of a calcified echinococcal cyst mimicking acute cholelithiasis is discussed. This case is of interest because the correct diagnosis was not recognized preoperatively despite the fact that certain aspects of the illness were classic features of this complication of hydatid disease. Although this is a common complication of hydatid disease, which is well recognized in other countries, only 7 cases have been reported in the American literature. Treatment of the patient included successful use of a Roux en Y drainage procedure, which, to the best of the authors' knowledge, has not previously been employed in treating this disease.
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