P-636: Hepatic hydatid cyst: a rare cause of abdominal pain in the older patient

摘要

Older patients have different particularities induced both by age changes and by associated pathology. Abdominal pain in an older patient is a frequent symptom with numerous causes, from ischemic, to tumoral, infectious, traumatic or multiple other cause. Hepatic echinococcosis is a severe parasitic disease that occurs worldwide, but there are insufficient data for older patients. We report a case of a 70-year-old patient from rural area admitted for abdominal pain, more accentuated in right upper quadrant pain. Additionally, the patient complains of nausea, pyrosis, appetite loss, height loss. The symptomatology gradually increased for the past 6 months. The patient has hypertension as concomitant disease. Complete blood count, liver enzymes were normal with no other pathological finding in serum labs. Abdominal ultrasonography showed a large tumoral mass in the liver. Computer tomography confirms the presence of a calcified hepatic hydatid cyst. Repeated blood pressure monitoring revealed uncontrolled hypertension. Her antihypertension medication as adjusted and also received symptomatic medication for abdominal pain. The patient has normal cognitive status, no depression, risk for malnutrition and pre-frail status. After diagnosis, evaluation and proper control of concomitant disease, the patient was referred to the general surgery. The surgery as with no complications and patient's symptomatology disappear gradually after surgery. Hepatic echinococcosis can be a rare cause of chronic, progressive abdominal pain in the older patient with long term consequence and risk for malnutrition.