A 26-year-old male patient from the highlands of Peru was admitted with a 2-month history of early satiety, nausea, and progressive dyspnea. The physical examination showed decreased breath sounds on the left lung and abdominal distention with multiple painless palpable masses. The chest X-ray showed a well-defined rounded cystic pulmonary lesion located in the left lower lobe (Figure 1A). The abdominal computed tomography scan revealed multiple thin-walled abdominal cystic lesions in the liver and spleen and within the abdominal cavity (Figure 1B and C). A serum Western blot test was positive for hydatidosis. Multiple hydatid cysts were surgically removed (Figure 1D). The patient was treated with a prolonged course of albendazole with good clinical evolution.
Hydatidosis caused by Echinococcus granulosus remains a major public health problem in developing countries. Disseminated intra-abdominal hydatidosis is an infrequent condition that usually results from the rupture of a liver cyst, with subsequent seeding of protoscolices in the abdominal cavity.1 There is no standard treatment for this disorder; careful surgical removal of the cysts and prolonged medical treatment with albendazole with or without praziquatel are recommended.2
Majbar MA, Souadka A, Sabbah F, Raiss M, Hrora A, Ahallat M, 2012. Peritoneal echinococcosis: anatomoclinical features and surgical treatment. World J Surg 36: 1030–1035.
Cobo F, Yarnoz C, Sesma B, Fraile P, Aizcorbe M, Trujillo R, Diaz-de-Liaño A, Ciga MA, 1998. Albendazole plus praziquantel versus albendazole alone as a pre-operative treatment in intra-abdominal hydatidosis caused by Echinococcus granulosus. Trop Med Int Health 3: 462–466.