Presentation
Blunt abdominal trauma one week ago. Mild abdominal pain thereafter.
Patient Data
A round opaque structure in the right iliac fossa.
No pneumoperitoneum.
series 1: A heterogenous relatively echogenic round lesion in the liver
series 2: A hypoechoic lesion with internal thick membrane in the liver
series 3: An arch-like echogenic structure with posterior shadowing in the gastric lumen
Keeping with context of trauma, CT exam was suggested.
CT exam obtained after one day
Topogram shows the round opacity is now seen more cranial to the previous x-ray. CT shows an oval-shaped dense structure noted in the lumen of the stomach at the antral region.
A multi-layered cystic lesion with internal crumpled membranes in segments II, III and 4B of the liver measuring 13.3 x 7 x 5.8 cm.
Another lesion with peripheral calcification and thick contents in segment II of liver measuring 3.8 x 5 3.6 cm. No enhancement in any phase.
Mild pelvic ascites is noted.
Gall bladder as well as intra and extra-hepatic biliary channels are normal.
Case Discussion
The features are of incidental finding of hepatic hydatid cyst. No trauma-related abnormality of the liver is seen. As there is mild pelvic ascites, the possibility of intraperitoneal rupture of the larger hepatic cystic lesion needs to be taken in consideration.
The history was remarkable for an ingested glass marble about eight years ago. which is still present in stomach.