Hydatid cyst - subdiaphragmatic

Case contributed by Dr Mostafa El-Feky


Indian patient presented with epigastric fullness and pain.

Patient Data

Age: 25 years
Gender: Male


A bilobed complex cystic lesion is noted at the subdiaphragmatic region, measuring 9.8 x 15 x 8.3 cm in AP, SS and CC dimensions. It shows regular smooth borders, heterogeneous hypodense texture with multiple rounded cystic components and fine curvilinear marginal calcifications. No internal enhancement noted.

It is widely contacting the undersurface of the left diaphragmatic copula, contacting the left hepatic lobe, splaying the upper pole of the spleen and indenting the serosal surface of the stomach fundus.

Normal surrounding fat planes and adjacent parenchymatous organs with no infiltration or evidence of rupture. Unremarkable lung bases.

Case Discussion

Features are suggestive of intraperitoneal hydatid disease. The marginal contact with multiple upper abdominal organs makes it difficult to consider the organ of origin. The diaphragm, being of the widest contact with the lesion, makes intraperitoneal subdiaphragmatic location more possibly.

The lesion imaging features are representing a benign complex lesion with multiple internal cysts, that makes hydatid cyst (type II) is the primary considered diagnosis.

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Case information

rID: 70262
Published: 18th Sep 2019
Last edited: 18th Sep 2019
Inclusion in quiz mode: Included
Institution: Dar El Ashaa Center

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