Abstract Isolated retroperitoneal hydatid cyst is an exceptionally rare entity. Owing to vague
and varied symptomatology, it is seldom diagnosed without puncture cytology or surgery. We
report an unusual presentation of primary retroperitoneal hydatid cyst with concomitant small
gut obstruction. Ultrasonography and computed tomography of the abdomen showed localized
abscess or pseudocyst of pancreas. Preoperatively, ultrasound-guided puncture cytology of the
lesion revealed suspicious hydatid pathology. The patient was examined and, peroperatively,
the cyst masqueraded as hydatid cyst of pancreas along with an inflammatory band, and the
diagnostic dilemma about its exact site of origin was solved by histopathology only. Complete
excision of the cyst along with the tail of pancreas was done with concomitant excision of
inflammatory band, causing small intestinal obstruction. The patient was discharged in satisfactory
condition on albendazole. In follow-up of 8 months, there was no recurrence.
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