We present the case of a 47 old man who suffered in 1989 a pancreatic resection for
the rupture of a pancreatic hydatic cyst, with consecutive peritonitis. He was treated
for many years with Albendazole, but ultrasound survey revealed new hepatic cysts,
and lab tests defined secondary diabetes mellitus.
In December 2007 the patient came to the ER, complaining of intense abdominal pain,
in the right upper quadrant, right lumbar pain and in the right shoulder, nausea and
wasting.
He had no fever, his skin was normal coloured, HR 80/min, BP 120/70mmHg, had a normal
pulmonary exam, abdominal palpation was painful in the right upper quadrant.
Lab tests revealed hyperglycemia (229mg/dl), the other parameters was in normal range.
Abdominal ultrasound showed a great number of hepatic cysts, of various size, with
enlargement of the main bile duct and multiple peritoneal cysts, the greatest in the
splenic hilum, of 17cm diameter and gallbladder stones.
An abdominal CT scan was performed that confirm the ultrasound aspect. It raised the
suspicion of a hepatic cyst rupture.
A surgical procedure was performed that consisted of resection of the peritoneal cysts
and of the visible hepatic cysts, with the normalization of the main bile duct diameter,
resolution of the pain symptoms. The patient will continue the antiparasitical treatment
with Albendazole.
