Right upper quadrant pain: a case where diagnosis was made from the chest X-Ray
Theocharis Koufakis, Anastasios Margaritis
The Pan African Medical Journal. 2014;17:60. doi:10.11604/pamj.2014.17.60.3494

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Right upper quadrant pain: a case where diagnosis was made from the chest X-Ray

Cite this: The Pan African Medical Journal. 2014;17:60. doi:10.11604/pamj.2014.17.60.3494

Received: 17/10/2013 - Accepted: 29/10/2013 - Published: 26/01/2014

Key words: Chest X-Ray, hydatid cyst, lung

© Theocharis Koufakis et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/17/60/full

Corresponding author: Theocharis Koufakis, General Hospital of Larissa, Department of Internal Medicine, Larissa, Greece (thkoyfak@hotmail.com)


Right upper quadrant pain: a case where diagnosis was made from the chest X-Ray

 

Theocharis Koufakis1,&, Anastasios Margaritis1

 

1General Hospital of Larissa, Department of Internal Medicine, Larissa, Greece

 

 

&Corresponding author
Theocharis Koufakis, General Hospital of Larissa, Department of Internal Medicine, Larissa, Greece

 

 

Image in medicine

A 90 years old woman, in good physical condition, and without history of chronic disease, smoking or alcohol abuse, presented to the Emergency Department of our Hospital, complaining about abdominal pain with a specific location at the right upper quadrant. Her symptoms started approximately a month ago. She was a farmer and a habitant of a Greek rural district. Her blood tests were all within the normal ranges, but her chest x-ray revealed a surprise at the right lower: a big, spherical cystic lesion with a characteristic calcified ring around it, coming out of the right lung. In view of this finding, the patient was admitted and abdominal computer tomography (CT) and ultrasound were performed, which demonstrated the typical imaging features of an hydatid cyst (8.5 x 9.5 cm) ,sited at the right lobe of the liver. Surgical treatment of the cyst was not preferred, because of the age of the patient and the possibility of postoperative complications. In her follow up, she remained in good health and free of symptoms. The differential diagnosis of liver hydatid cyst includes polycystic liver disease, hepatic abscess, hepatocellular carcinoma, hepatic and amebic cysts, but the very specific imaging findings in CT are usually enough to establish the diagnosis. In conclusion, this case underlines the diagnostic value of the chest x-ray which remains the keystone imaging method for any clinical physician. Furthermore, echinococcosis, although considered as a "forgotten" disease, still remains a public health problem for many epidemic areas around the world.

Figure 1: A large hydatid cyst coming from the right lobe of the liver with the characteristic calcified ring around it

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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