Alveolar ecchinococcosis (AE) is a rare but potentially life-threatening serious parasitic disease. The parasit may involve liver and, most importantly, expand vessels and biliary tract. We present here a case of esophageal variceal bleeding due to portal hypertension and cholestasis secondary to AE. We present the case of a 30-year-old female patient who was admitted to emergency service with hematemesis, melena and icter. Upper gastrointestinal endoscopy revealed gastroesophageal varices and portal gastropathy. Contrasted computerized tomography examination showed a solid calcific lesion (cross dimension 6×11 and 5×9 cm.) of biliary tracts causing dilatation. An USG guided biopsy from the mass was performed and histological examination revealed AE. We also review here the literature on portal hypertension and cholestasis due to Echinococcus alveolaris. AE is rare a disease and may cause severe complications. Endoscopic and percutaneous drainage for biliary obstruction caused by hepatic AE has a palliative effect even in the late stages. Liver transplantation was recommended but this operation was not performed for living donor shortage. Liver transplantation should be considered in the management of advanced liver alveolar echinococcosis.
Portal hypertension, cholestasis, Echinococcus alveolaris