This is an 81-year-old woman with no history of interest who complained of progressive dyspnea until rest without fever thermometered, accompanied by significant tachypnea with the use of accessory muscles, orthopnea 3 pils.
Blood tests revealed leukocytosis 28,800/mm3 with 3% of falls, pO2 56%, SatO2 84%.
The clinical examination revealed marked jugular engorgement (5 cm), edema in the lower limbs up to the knees, tachypnea at 28 rpm, crackles to middle fields, hepatomegaly of 6 cm and tones.
The ECG showed poor voltage in precordial leads and high S-T of V4-V6 and lower face.
The chest X-ray showed cardiomegaly with a boot image and bilateral costophrenic pinch.
A chest CT scan showed a large cystic liver lesion located in the left lobe extending to the pericardium.
Given the clinical situation she was admitted to the ICU requiring orotracheal intubation (OTI) and hemodynamic support, where, under local anesthesia, an incision was made in the left hypochondrium, draining 1,200 cc of purulent material.
After presenting hemodynamic and posterior improvement, it was decided to perform an intervention under general anesthesia, performing aotomy, objectivizing hepatic hydatid cyst with drainage of the thorax and communicating with pericardium, performing a subxiphoid window and pericystectomy.
The subsequent evolution was favorable.
