Hepatothoracic hydatid transit with septic pulmonary embolism

Osorio Aira, S.; López Pedreira, M.R.

doi:10.1016/j.rceng.2019.05.017

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The physician performed a chest radiography (anterior-posterior and lateral) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B), which revealed numerous nodular images in both hemithoraces, with a typical “balloon release” image, suggesting metastases as the first possibility. Contrast-enhanced chest computed tomography (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C–E) was therefore performed, which confirmed the presence of numerous nodular images of cystic density, spread around both hemithoraces, some located in the interior of the segmental branches of the pulmonary artery. In the abdominal slices, a cystic image was also observed, which bulged the diaphragm, in the process of hepatothoracic transit. The radiological findings were suggestive of hepatothoracic hydatid transit with septic pulmonary embolisms.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The decision was made to complete the study with computed tomography angiography of the pulmonary arteries (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>F–J) with the gemstone spectral imaging technique (spectral CT), which confirmed the suspected diagnosis. In the iodine-water color maps, a bilateral mosaic pattern was observed, which was compatible with the abnormal ventilation/perfusion ratio secondary to the embolisms.The confirmation diagnosis of hydatidosis was performed with immunochromatography to detect specific antibodies, which resulted positive (reading >11 units), as well as IgG (ELISA technique) for positive hydatidosis. Medical treatment was prescribed with albendazole, which improved the patient’s symptoms. The patient is currently undergoing medical and radiological follow-up." 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Revista Clínica Española (English Edition)

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Vol. 221. Issue 2.

Pages 127 (February 2021)

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