Icterus and abdominal pain: an unexpected, rare sonographic finding in a Peruvian Emergency Department

Critical Ultrasound Journal
Stephanie J Doniger, Alexander Wang

Abstract

The use of point-of-care ultrasound (POCUS) has become increasingly important in resource-limited settings. It can rapidly diagnose both tropical infectious diseases and more common pathology at the bedside. In these practice settings, POCUS can have a significant impact on management strategies and patient care. Ultrasonography has been the gold standard for the diagnosis and staging of Echinococcus disease. However, even in the "classic" clinical scenario and setting, the clinician must maintain a broad differential diagnosis. Point-of-care ultrasound can be helpful in performing the rapid diagnosis and therefore direct appropriate treatment strategies based on the results. We present a case of a 27-year-old woman presenting to an emergency department in Peru with jaundice and abdominal pain. Initially given the region of her origin, the working diagnosis was an Echinococcus cyst. However, when POCUS was performed, the findings were not consistent with hydatid disease. Ultimately, surgical pathology revealed a choledochal cyst, a rare finding in adulthood. This case initially appears as a "classic" finding of Echinococcus disease. It is important for the clinician sonographer to appreciate the features consistent with Echinoc...Continue Reading

References

May 1, 1981·Radiology·H A GharbiK Dupuch
Feb 9, 2008·Emerging Infectious Diseases·Cesar M GavidiaRobert H Gilman
Dec 3, 2014·Journal of the American College of Surgeons·Kevin C SoaresTimothy M Pawlik

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