Hydatid cyst of the liver: When fistulization reaches the portal trunk

Hydatidosis is a major health problem in Morocco, mainly affecting rural regions due to traditional livestock breeding practices. Complications of hepatic hydatid cyst include fistulization into the biliary tract, with a rare complication of fistulization into the portal vein. We present the case of a 71-year-old patient with a hydatid cyst fistulized into the right branch of the portal vein. Diagnosis is based on biological and imaging examinations. Surgical management is complex due to the hemorrhagic risk. Clinical and radiological monitoring is sometimes preferred. The management of such situations remains a clinical challenge requiring multidisciplinary expertise to ensure optimal outcomes.