Naila Nadeem, Hassan Khan, Saulat Fatimi, Mohammad Nadeem Ahmad.
Giant multiple intra-abdominal Hydatid cysts.
J Ayub Med Coll Abottabad Jan ;18(4):70-1.

A 42 yr old lady presented with shortness of breath on exertion, orthopnea and progressively increasing abdominal distention. She had past history of hydatid disease and had three laparatomies and a right thoracotomy, in the past five years. On physical examination, she was an extremely thin woman with a large protruding abdomen. Her abdomen was distended but nontender. Her vital signs were- pulse of 92/minute, Blood pressure was 95/60 mmHg, Respiratory rate of 24/min and temperature of 37 degrees centigrade. She had decreased breath sounds in both lower lung fields. Rest of the physical examination was unremarkable. Her routine laboratory investigations were normal. Echinococcus antibody titres were 1:64 (Normal 1:32). The CT (Computed Tomography) scan revealed multiple, well defined cysts throughout the abdomen. A few cysts showed septae and daughter cysts. These cysts were producing a pressure affect on surrounding structures but not invading them. Appearance is consistent with multiple hydatid cysts She was offered another laparotomy and right thoracotomy but the patient refused to undergo any further surgical procedure. She was discharged from the clinic with a prescription of Albendazole 400 mg twice a day for an indefinite period. The patient never returned for follow up later.

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