PMC7475761_01
Massive hepatomegaly on clinical examination and ultrasonography showing 3 giant (>= 10 cm) cysts involving both the liver lobes.
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Physical examination revealed massive hepatomegaly, and ultrasonography showed 3 giant (>=10 cm) cysts involving both the liver lobes as shown in Figure 1.
Abdominal CT scan showing multiple cysts with floating membranes in hepatic segments 2, 3, 6, and 7 with features favoring hydatid etiology.
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Intraoperative appearance of multiple liver hydatid cysts.
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Following 3 weeks of oral albendazole therapy (10 mg/kg/day in 2 divided doses), he underwent laparotomy with cyst aspiration as shown in Figure 3.
Contents of fluid aspirates from the hepatic hydatid cysts grossly and under microscopy showing free hooklets.
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Aspiration revealed clear fluid from the 2 subphrenic cysts and bile-stained aspirates from the cyst over the under surface of the liver, cytology of which showed free hooklets as shown in Figure 4.
Non-bile-stained membranes within the subphrenic cysts and bile-stained ones in the cyst over the under surface of the liver.
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The cysts were then opened, membranes evacuated as shown in Figure 5, and a careful search for a cyst-biliary communication was done, but not found.
Histopathological appearance of the membranes showing laminated cuticular layer with protoscolex of Echinococcus granulosus.
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