A 59-year-old woman with no history of interest was admitted for pain in the right epigastric-hypochondrium radiating to the scapula together with jaundice and food intolerance for 5 days.
On physical examination, the patient was often 80 bpm, afflicted with mental illness, mental illness, mental illness, mental illness, mental illness, mental illness and mental illness.
Emergency laboratory analysis showed a total bilirubin of 11.63, specifically direct bilirubin (7.12), amylase of 135, GPT 221, LDH57, leukocytosis of 14.400 normal value and 080 normal.
Abdominal ultrasound showed a well-defined cystic lesion in the right hepatic lobe of 6.9 x 6 cm compatible with hydatid cyst and multiple gallstones.
Vesicle, body of pancreas, kidneys, spleen and bladder were normal.
Not free peritoneal fluid.
The patient was treated with albendazole.
After one day of admission the patient presented an episode of anaphylactic shock with dyspnea and desaturation (pO2 50 mmHg, SatO2 86.9), fever (38o), bilateral wheezing.
Abdominal CT scan of the emergency room showed no new data with respect to ultrasound. After intravenous administration of 80 mg of hydatidiformis V-segment and 1 IV ampulla of Polaramine®, the patient underwent emergency surgery due to anaphylaxis.
Intraoperative ultrasound showed a cyst in contact with inferior vena cava and right suprahepatic vein.
Puncture, aspiration and sterilization with hypertonic saline were performed in addition to cholecystectomy and cholecystectomy.
After 15 days of clinical and laboratory improvement, the patient was discharged on albendazole treatment.
