Hepatic hydatid cyst - ultrasound water lily sign
Referred to the Emergency Department for a FAST scan after sustaining blunt abdominal trauma. Otherwise asymptomatic.
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A well-defined cystic lesion measuring 8.0 cm x 6.5 cm x 7.4 cm in the right lobe of the liver (segment VII/VIII) with low-level internal echoes. The cyst shows a detached, irregular laminated membrane inside it which appears to float within the contents of the cyst.
Rest of the study is unremarkable.
The findings are suggestive of a hepatic hydatid cyst with ultrasound "water lily sign". According to the WHO classification of hepatic hydatid cysts, the water-lily sign is seen in stage CE3a, which represents a transitional stage between active and inactive disease. The mechanism of detachment of membrane is related to decreased intra-cystic pressure, degeneration, host response, trauma or following therapy.
- 1. Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS. Hydatid disease: radiologic and pathologic features and complications. (2000) Radiographics : a review publication of the Radiological Society of North America, Inc. 20 (3): 795-817. doi:10.1148/radiographics.20.3.g00ma06795 - Pubmed
- 2. Antonio Giorgio, Antonella Di Sarno, Giorgio de Stefano, et al. Sonography and Clinical Outcome of Viable Hydatid Liver Cysts Treated With Double Percutaneous Aspiration and Ethanol Injection as First-Line Therapy: Efficacy and Long-Term Follow-Up. (2012) American Journal of Roentgenology. 193 (3): W186-92. doi:10.2214/AJR.08.1518 - Pubmed