Presentation
Chronic epigastric and right hypochondrium pain with recent back pain.
Patient Data
Saccular aneurysmal dilatation of the abdominal aorta measuring about 10 x 5 x 4.5 cm in CC x AP x TS diameters respectively. The width of its neck measures 2.5 cm in longitudinal diameter. The aneurysm extends from T11 to L1 level, just above the level of superior mesenteric and renal arteries.
Prevertebral heterogeneously enhancing soft tissue mass engulfs the aneurysm and at the same time causing destruction of the T11 and T12 vertebral bodies. Two largest cystic components of the soft tissue mass are located next to the crus of right hemidiaphragm and lower chest between the aorta and esophagus respectively. There are multiple intra-abdominal cystic lesions, some of them with daughter cysts and areas of wall calcification are seen in the right and left kidneys as well as in the left hepatic lobe.
Case Discussion
Hydatid cyst is a common disease in developing countries (larval stage of tapeworm of the Echinococcus granulosus) and can be seen anywhere, most commonly at the liver (75%) and lungs (15%) but can be seen in the pericardium, breast, muscles, bones, retroperitoneal, mesenteric and adnexal region.
A mycotic aneurysm is due to arterial wall infection.
Mycotic aortic aneurysm due to a rupture hydatic cyst is one of the rarest but most dangerous complications.
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