Peritoneal hydatid cyst: an unusual cause of abdominal pain in a haemodialysis patient.

A 22-year-old man with end-stage renal disease on haemodialysis (HD) was admitted to our hospital with a generalized abdominal pain. He had been on HD without complications the previous year. One year before admission, peritoneal dialysis was discontinued because of peritonitis due to candida infection. At physical examination, his blood pressure was 150/90mmHg and heart rate was 90 b.p.m. His abdomen was soft but tender and there was a mass (15 15 cm) at the periumbilical region. Laboratory examination results were as follows: peripheral white blood cell count 7800 (4.400–11.000 cells/ml) (73% were neutrophils, 17% lymphocytes); haematocrit 18.4% (41–50%), sodium 134mmol/l (136–145mmol/l), potassium 4.2mmol/l (3.4–4.5mmol/l), Cl 96mmol/l (96–108mmol/l), urea 71mmol/l (2.50–7.50mmol/l), creatinine 6.8mg/dl/l (0.7–1.5mg/dl), glucose 92mg/dl (70–110mg/dl), and C-reactive protein 93mg/l (0–5mg/l). A septated intraperitoneal cystic mass suggesting hydatid cyst was detected on ultrasonography (Figure 1). The MRI of the abdomen was performed with a 1.5-T magnetic unit (Magnetom Symphony, Siemens, Erlangen, Germany) in order to gain further information on the cystic mass. The Cystic mass showed similar characteristics on MRI (Figure 2). The mass was 4 10 16 cm in size in the peritoneal cavity, and had no contrast enhancement and pericystic invasion. No other lesion was demonstrable in any organ. The patient underwent the operation without complications and then his functions were stable following the intervention. Hydatidosis was confirmed histopathologically by demonstrating protoscolex in the cyst content. Albendasole was started 2 400mg/day. Fig. 1. Abdominal ultrasonography shows septated cystic mass in the peritoneal cavity.