Cyst at the hepato-pancreatic groove: A diagnostic challenge

Cyst at the hepato-pancreatic groove: A diagnostic challenge | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Cyst at the hepato-pancreatic groove: A diagnostic challenge Koushik Mukherjee, Devendra Singh Kushwaha, Shreya Saha, Arghya Samanta, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6416559/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Cystic lesions at hepato-pancreatic groove has many differentials such as enteric duplication cyst, choledochal cyst and often leads to diagnostic dilemma and confusion. It is of paramount importance to diagnose them correctly as treatment differs. Case presentation : Hereby, we report a 9-year-old boy who presented with obstructive jaundice with cholangitis due to a large cystic lesion in hepato-pancreatic groove, which was finally diagnosed intraoperatively as hydatid cyst, a rare entity at that location. Conclusion: Hydatid cyst should be considered in the differential diagnosis of cystic lesions at hepato-pancreatic groove, especially in the presence of non-specific radiological features for better clinical outcome. Cyst Hepato-pancreatic groove hydatid cyst Figures Figure 1 Introduction Hydatid disease, also known as cystic echinococcosis, is a parasitic infection caused by the larval stage of Echinococcus granulosus or, less commonly, Echinococcus multilocularis . The parasite lifecycle involves canines as definitive hosts and livestock as intermediate hosts, with humans acting as accidental hosts when they ingest parasite eggs from contaminated water. Once inside the human body, eggs hatch into larvae, which then migrate to different organs of the body. It primarily affects the liver but which can be found anywhere in the body. 1 We hereby report a child with a cystic lesion at hepato-pancreatic groove that posed significant diagnostic dilemma. Case presentation A 9-year-old boy presented with a history of jaundice with clay-coloured stools for the last 5–6 months, and an upper abdominal lump noticed for the last 2 months. There was no history of fever, pain abdomen or prodromal symptoms. Physical examination revealed icterus, anemia and the aforementioned upper abdominal lump. The rest of the systemic examination was unremarkable. His hemoglobin was 9.6 g/dl, total leukocyte count was 4.5x 10 3 /µl and platelet count was 175 × 10 3 /µl. His liver function test showed a total bilirubin of 16 mg/dL, direct bilirubin 9.8 mg/dL, aspartate aminotransferase (AST) of 132 U/L, alanine aminotransferase of 87 U/L, alkaline phosphatase (ALP) of 837 U/L and gamma glutamyl transpeptidase (GGT). His ultrasound abdomen revealed an 8.5 × 6.7 cm cystic mass at the porta hepatis near the head of the pancreas, with dilatation of the intrahepatic and proximal common bile duct (CBD). Contrast-enhanced computed tomography (CECT) scan of the abdomen showed a large (11 × 9 cm)thick-walled cystic lesion within the hepatopancreatic groove/hepatic hilar groove with fine debris, without any obvious biliary or enteric communication (Fig. 1 A). The radiological possibility was a duodenal duplication cyst. Magnetic resonance cholangiopancreatography (MRCP) showed a large cystic lesion at the hepato-pancreatic groove, causing external compression on the lower part of CBD, leading to dilated proximal CBD and intrahepatic bile ducts (Fig. 1 B). Endoscopic ultrasonography (EUS) was planned but could not be performed due to technical difficulties. Endoscopic retrograde cholangio-pancreatography (ERCP) was attempted but failed due to narrowing at the first part of the duodenum. Prior to elective surgery, a percutaneous transhepatic biliary drainage (PTBD) was performed, following which total bilirubin decreased to 7.4 mg/dl. Fluid aspirated during PTBD insertion showed a total leukocyte count of 1560 cells/mm 3 with 90% neutrophils and sterile culture. One week later, the child got readmitted with biliary peritonitis following accidental removal of the PTBD tube. The child underwent emergency damage control surgery (DCS). The cyst (10x8 cm) was found in the duodeno-pancreatic groove, at the head of the pancreas region, compressing the duodenum with necrosis of the same (resulting in bile leakage) [figure 1 C]. Clear cystic fluid and laminated membranes were found, suggestive of a hydatid cyst [figure 1 D]. De-roofing of the cyst was performed, along with excision of necrosed areas of the pylorus and duodenum. There was torrential bleeding intra-op during the first surgery along with hypotension, which was well controlled. The definitive management in this case would have been a Whipple’s procedure, but the patient needed optimisation before that. The second surgery’s aim was to establish an enteric feeding channel as there was no bowel continuity post DCS. But after the second surgery, he could not be extubated due to worsening chest complications. He expired in the post-operative period from multi-organ failure. Discussion Hydatid cyst is a zoonotic disease in humans caused by Echinococcus granulosus . The most commonly affected organ is the liver (50–70%), followed by the lungs (15–40%), spleen and kidney. 1 Hydatid cyst of hepato-pancreatic groove is an extremely uncommon site of involvement that poses diagnostic and therapeutic challenges. 2 The radiological mimickers in children are pancreatic pseudocyst, enteric duplication cyst, and choledochal cyst, as was the case in our patient. It may present asymptomatically or causes compressive symptoms (obstructive jaundice, duodenal obstruction or pancreatitis), as was found in our case. Preoperative differentiation between hydatid cyst and other etiologies is important to avoid intra-operative and post-operative complications (hypersensitivity due to spillage, peritoneal seeding). Imaging in the form of CT abdomen, MRI or endoscopic ultrasound (EUS) are helpful for differentiation and characterization of the cysts. 3 However, sometimes they might fail to differentiate, as was found in our case. Surgical excision is the definitive treatment 4 . To prevent spillage causing anaphylactic reaction and peritoneal dissemination, the cyst is sterilized prophylactically with a scolicidal solution. Conclusion To conclude, hydatid cyst of pancreato-hepato-biliary groove is rare entity, having radiological mimickers that often pose significant diagnostic and therapeutic dilemmas. It should be considered as a differential of any cystic lesion in the pancreato-hepato-biliary groove. Abbreviations ERCP Endoscopic retrograde cholangio-pancreatography MRCP Magnetic resonance cholangiopancreatography EUS Endoscopic ultrasonography PTBD percutaneous transhepatic biliary drainage DCS damage control surgery Declarations Ethical approval : Not applicable Consent for participation : Taken Consent for publication : Taken Data availability: No datasets were generated or analysed during the current study. Code availability: Not applicable. Author contributions: KM: Performed literature review,wrote initial manuscript and did revision. DSK: Performed literature review, wrote initial manuscript and did revision. SS: Involved in surgical management, literature review, did revision of manuscript. AS: Performed literature review and critical revision of manuscript. GR: Performed literature review and critical revision of manuscript. All authors approved final manuscript Funding : None received Conflict of interest : All authors declare no conflict of interest. References Yuksel M., Demirpolat G., Sever A., Bakaris S., Bulbuloglu E., Elmas N. Hydatid disease involving some rare locations in the body: a pictorial essay. Korean J. Radiol. 2007 Dec 1;8(6):531–540. Jan ZU, Ahmed N, Khan MY, Samin Y, Sohail R. Hydatid cyst of the hepatopancreatic groove - A case report. Int J Surg Case Rep . 2023;111:108771. Missas S., Gouliamos A., Kourias E., Kalovidouris A. Primary hydatid disease of the pancreas. Gastrointest. Radiol. 1987;12:37–38. Jai S.R., El Hattabi K., Bensardi F., Chehab F., Khaiz D., Bouzidi A. Primary hydatid cyst of the pancreas causing obstructive jaundice. Saudi J. Gastroenterol. 2007 Oct 1;13(4):191. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6416559","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":452473283,"identity":"d820d736-4ea0-47a8-8108-084ebf17660e","order_by":0,"name":"Koushik Mukherjee","email":"","orcid":"","institution":"Institue of postgraduate medical education and research","correspondingAuthor":false,"prefix":"","firstName":"Koushik","middleName":"","lastName":"Mukherjee","suffix":""},{"id":452473284,"identity":"ccdf22bb-345b-4a86-a12d-405c0b2fe2cc","order_by":1,"name":"Devendra Singh Kushwaha","email":"","orcid":"","institution":"Institue of postgraduate medical education and research","correspondingAuthor":false,"prefix":"","firstName":"Devendra","middleName":"Singh","lastName":"Kushwaha","suffix":""},{"id":452473285,"identity":"dfb8c7e9-599a-43c5-a63b-09b8bc18c2a8","order_by":2,"name":"Shreya Saha","email":"","orcid":"","institution":"Institue of postgraduate medical education and research","correspondingAuthor":false,"prefix":"","firstName":"Shreya","middleName":"","lastName":"Saha","suffix":""},{"id":452473286,"identity":"26c759d3-795f-4a36-8310-41c6c6904e4e","order_by":3,"name":"Arghya Samanta","email":"data:image/png;base64,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","orcid":"","institution":"Institue of postgraduate medical education and research","correspondingAuthor":true,"prefix":"","firstName":"Arghya","middleName":"","lastName":"Samanta","suffix":""},{"id":452473287,"identity":"b514e6c3-5e2f-4dbe-aedd-e3686e6eb861","order_by":4,"name":"Gautam Ray","email":"","orcid":"","institution":"Institue of postgraduate medical education and research","correspondingAuthor":false,"prefix":"","firstName":"Gautam","middleName":"","lastName":"Ray","suffix":""}],"badges":[],"createdAt":"2025-04-10 05:23:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6416559/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6416559/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87321202,"identity":"b8eca233-b0d1-4cdb-a152-d4156523e174","added_by":"auto","created_at":"2025-07-22 16:35:16","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":823543,"visible":true,"origin":"","legend":"\u003cp\u003eA: Contrast enhanced computed tomography (CECT) scan of the abdomen showing a large thick walled cystic lesion within the hepatopancreatic groove/hepatic hilar groove with fine debris ( white arrow).\u003c/p\u003e\n\u003cp\u003eB: Magnetic resonance cholangiopancreatography (MRCP) showing a large cystic lesion at the hepato-pancreatic groove ( white arrow) \u0026nbsp;causing external compression on lower part of common bile duct (CBD), leading to dilated proximal CBD and intrahepatic bile ducts.\u003c/p\u003e\n\u003cp\u003eC: Intra-operative image showing the cyst (black arrow), with clear fluid being aspirated.\u003c/p\u003e\n\u003cp\u003eD: Intra-operative image showing membranes, characteristic of hydatid cyst (black arrow).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6416559/v1/6419f1bc3e330f9e03f3326a.png"},{"id":100045205,"identity":"ede54b44-a9e0-4c26-9b37-3943cc2dc540","added_by":"auto","created_at":"2026-01-12 11:55:02","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1104765,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6416559/v1/36c4dc12-8c3a-486c-9306-7a55bb02ffa2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003e Cyst at the hepato-pancreatic groove: A diagnostic challenge\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHydatid disease, also known as cystic echinococcosis, is a parasitic infection caused by the larval stage of \u003cem\u003eEchinococcus granulosus\u003c/em\u003e or, less commonly, \u003cem\u003eEchinococcus multilocularis\u003c/em\u003e. The parasite lifecycle involves canines as definitive hosts and livestock as intermediate hosts, with humans acting as accidental hosts when they ingest parasite eggs from contaminated water. Once inside the human body, eggs hatch into larvae, which then migrate to different organs of the body. \u003cb\u003eIt\u003c/b\u003e primarily affects the \u003cb\u003eliver\u003c/b\u003e but which can be found anywhere in the body.\u003csup\u003e1\u003c/sup\u003e We hereby report a child with a cystic lesion at hepato-pancreatic groove that posed significant diagnostic dilemma.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Case presentation","content":"\u003cp\u003eA 9-year-old boy presented with a history of jaundice with clay-coloured stools for the last 5–6 months, and an upper abdominal lump noticed for the last 2 months. There was no history of fever, pain abdomen or prodromal symptoms. Physical examination revealed icterus, anemia and the aforementioned upper abdominal lump. The rest of the systemic examination was unremarkable. His hemoglobin was 9.6 g/dl, total leukocyte count was 4.5x 10\u003csup\u003e3\u003c/sup\u003e/µl and platelet count was 175 × 10\u003csup\u003e3\u003c/sup\u003e /µl. His liver function test showed a total bilirubin of 16 mg/dL, direct bilirubin 9.8 mg/dL, aspartate aminotransferase (AST) of 132 U/L, alanine aminotransferase of 87 U/L, alkaline phosphatase (ALP) of 837 U/L and gamma glutamyl transpeptidase (GGT). His ultrasound abdomen revealed an 8.5 × 6.7 cm cystic mass at the porta hepatis near the head of the pancreas, with dilatation of the intrahepatic and proximal common bile duct (CBD). Contrast-enhanced computed tomography (CECT) scan of the abdomen showed a large (11 × 9 cm)thick-walled cystic lesion within the hepatopancreatic groove/hepatic hilar groove with fine debris, without any obvious biliary or enteric communication (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA). The radiological possibility was a duodenal duplication cyst. Magnetic resonance cholangiopancreatography (MRCP) showed a large cystic lesion at the hepato-pancreatic groove, causing external compression on the lower part of CBD, leading to dilated proximal CBD and intrahepatic bile ducts (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eB). Endoscopic ultrasonography (EUS) was planned but could not be performed due to technical difficulties. Endoscopic retrograde cholangio-pancreatography (ERCP) was attempted but failed due to narrowing at the first part of the duodenum. Prior to elective surgery, a percutaneous transhepatic biliary drainage (PTBD) was performed, following which total bilirubin decreased to 7.4 mg/dl. Fluid aspirated during PTBD insertion showed a total leukocyte count of 1560 cells/mm\u003csup\u003e3\u003c/sup\u003e with 90% neutrophils and sterile culture. One week later, the child got readmitted with biliary peritonitis following accidental removal of the PTBD tube. The child underwent emergency damage control surgery (DCS). The cyst (10x8 cm) was found in the duodeno-pancreatic groove, at the head of the pancreas region, compressing the duodenum with necrosis of the same (resulting in bile leakage) [figure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eC]. Clear cystic fluid and laminated membranes were found, suggestive of a hydatid cyst [figure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eD]. De-roofing of the cyst was performed, along with excision of necrosed areas of the pylorus and duodenum. There was torrential bleeding intra-op during the first surgery along with hypotension, which was well controlled. The definitive management in this case would have been a Whipple’s procedure, but the patient needed optimisation before that. The second surgery’s aim was to establish an enteric feeding channel as there was no bowel continuity post DCS. But after the second surgery, he could not be extubated due to worsening chest complications. He expired in the post-operative period from multi-organ failure.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eHydatid cyst is a zoonotic disease in humans caused by \u003cem\u003eEchinococcus granulosus\u003c/em\u003e. The most commonly affected organ is the liver (50\u0026ndash;70%), followed by the lungs (15\u0026ndash;40%), spleen and kidney.\u003csup\u003e1\u003c/sup\u003e Hydatid cyst of hepato-pancreatic groove is an extremely uncommon site of involvement that poses diagnostic and therapeutic challenges.\u003csup\u003e2\u003c/sup\u003e The radiological mimickers in children are pancreatic pseudocyst, enteric duplication cyst, and choledochal cyst, as was the case in our patient. It may present asymptomatically or causes compressive symptoms (obstructive jaundice, duodenal obstruction or pancreatitis), as was found in our case. Preoperative differentiation between hydatid cyst and other etiologies is important to avoid intra-operative and post-operative complications (hypersensitivity due to spillage, peritoneal seeding). Imaging in the form of CT abdomen, MRI or endoscopic ultrasound (EUS) are helpful for differentiation and characterization of the cysts.\u003csup\u003e3\u003c/sup\u003e However, sometimes they might fail to differentiate, as was found in our case.\u003c/p\u003e\u003cp\u003eSurgical excision is the definitive treatment\u003csup\u003e4\u003c/sup\u003e. To prevent spillage causing anaphylactic reaction and peritoneal dissemination, the cyst is sterilized prophylactically with a scolicidal solution.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eTo conclude, hydatid cyst of pancreato-hepato-biliary groove is rare entity, having radiological mimickers that often pose significant diagnostic and therapeutic dilemmas. It should be considered as a differential of any cystic lesion in the pancreato-hepato-biliary groove.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eERCP\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEndoscopic retrograde cholangio-pancreatography\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMRCP\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMagnetic resonance cholangiopancreatography\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eEUS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEndoscopic ultrasonography\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePTBD\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003epercutaneous transhepatic biliary drainage\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eDCS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003edamage control surgery\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e: Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for participation\u003c/strong\u003e: Taken\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e: Taken\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability:\u0026nbsp;\u003c/strong\u003eNo datasets were generated or analysed during the current study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCode availability:\u003c/strong\u003e Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKM: Performed literature review,wrote initial manuscript and did revision.\u003c/p\u003e\n\u003cp\u003eDSK: Performed literature review, wrote initial manuscript and did revision.\u003c/p\u003e\n\u003cp\u003eSS: Involved in surgical management, literature review, did revision of manuscript.\u003c/p\u003e\n\u003cp\u003eAS: Performed literature review and critical revision of manuscript.\u003c/p\u003e\n\u003cp\u003eGR: Performed literature review and critical revision of manuscript.\u003c/p\u003e\n\u003cp\u003eAll authors approved final manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e: None received\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e: All authors declare no conflict of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003e Yuksel M., Demirpolat G., Sever A., Bakaris S., Bulbuloglu E., Elmas N. Hydatid disease involving some rare locations in the body: a pictorial essay. Korean J. Radiol. 2007 Dec 1;8(6):531\u0026ndash;540.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Jan ZU, Ahmed N, Khan MY, Samin Y, Sohail R. Hydatid cyst of the hepatopancreatic groove - A case report. \u003cem\u003eInt J Surg Case Rep\u003c/em\u003e. 2023;111:108771.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Missas S., Gouliamos A., Kourias E., Kalovidouris A. Primary hydatid disease of the pancreas. Gastrointest. Radiol. 1987;12:37\u0026ndash;38.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Jai S.R., El Hattabi K., Bensardi F., Chehab F., Khaiz D., Bouzidi A. Primary hydatid cyst of the pancreas causing obstructive jaundice. Saudi J. Gastroenterol. 2007 Oct 1;13(4):191.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cyst, Hepato-pancreatic groove, hydatid cyst","lastPublishedDoi":"10.21203/rs.3.rs-6416559/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6416559/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction: \u003c/strong\u003eCystic lesions at hepato-pancreatic groove has many differentials such as enteric duplication cyst, choledochal cyst and often leads to diagnostic dilemma and confusion. It is of paramount importance to diagnose them correctly as treatment differs.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase presentation\u003c/strong\u003e: Hereby, we report a 9-year-old boy who presented with obstructive jaundice with cholangitis due to a large cystic lesion in hepato-pancreatic groove, which was finally diagnosed intraoperatively as hydatid cyst, a rare entity at that location.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eHydatid cyst should be considered in the differential diagnosis of cystic lesions at hepato-pancreatic groove, especially in the presence of non-specific radiological features for better clinical outcome.\u003c/p\u003e","manuscriptTitle":"Cyst at the hepato-pancreatic groove: A diagnostic challenge","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-22 16:35:11","doi":"10.21203/rs.3.rs-6416559/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"98be0763-1033-4afa-b10e-1db7198680d9","owner":[],"postedDate":"July 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-12T11:54:45+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-22 16:35:11","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6416559","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6416559","identity":"rs-6416559","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}