8th Eurasian Congress of Emergency Medicine & 18th Emergency Medicine Congress of Turkey & 17th World Interactive Network Focused on Critical Ultrasound Congress, Antalya, Turkey, 01 December 2022
RENAL HYDATIC CYST IN A PATIENT WITH FLANK PAIN: A CASE REPORT
Gülsah Ucan, Buse Goktas, Mustafa Emin Canakci, Filiz Baloglu Kaya, Nurdan Acar
Eskisehir Osmangazi University, Department of EmergencyMedicine, Eskisehir
INDRODUCTION: Hydatid cyst is an endemic parasitic disease caused by eccinococcus granulosus larvae in people with animal contact. The hydatid cyst is mostly located in the liver, and the second most frequently in the lung. Involvement of organs other than the liver or lung is unusual but can lead to significant morbidity and mortality. In this case report, we discussed a patient with renal hydatid cystin our emergency department.
CASE: A 23-year-old male patient presented with complaints of left flank pain and dysuria for 2 days. The patient's body temperature was 38oC, and other vitals were stable. He had no additional disease in thehistory and drug use. There was costovertebral angle tenderness at left. Laboratory examination (complete blood count, biochemistry parameters and urinalysis) was evaluated as normal. A cystic lesion was observed in the left kidney on point of care ultrasound. The patient's pain did not improve despite treatment. Abdominal contrast-enhanced computed tomography imaging of the patientrevealed a cystic lesion consistent with hydatid cyst in the left kidney and perirenal stranding (Figures 1 and 2). The patient was admitted to the urology clinic for cyst excision /treatment and follow-up.
CONCLUSION: Hydatid cyst is often asymptomatic. The liver is affected in about two-thirds of patients, the lungs in about 25 percent, and other organs such as the brain, muscle, kidney, bone, heart, and pancreas in a small percentage of patients. Renal involvement represents 2-4% of confirmed cases of hydatid disease. Cysts in the kidney may cause hematuria or flank pain, or they may open into the retroperitoneum, leading to morbidity and mortality. The diagnosis of hydatid cyst is made by evaluating the clinical, radiological and laboratory findings together. Flank pain is a common complaint in the emergency department and is observed especially due to renal colic and urinary system infections. However, although it is rare, patients should be evaluated/ doctors should be aware for hydatid cyst, especially of patients with animal contact. In patients with flank pain, rare etiologies should be kept in mind and appropriate referral should be made to prevent possible complications. Hydatid cyst should be included in the preliminary diagnosis, especially when evaluating other etiologies with point of care ultrasound.
Keywords: emergency department, flank pain, hydatid cyst