A patient presenting with abdominal pain to the general practitioner: a case report.
BACKGROUND
Right-sided upper abdominal pain is a common cause of presentation to general practitioners.


METHODS
An otherwise well 46-year-old woman presented to her general practitioner with intermittent abdominal pain that had been present for several months. The only abnormality found at the initial consultation was moderate tenderness in the right upper abdomen. The laboratory tests that were ordered showed elevated parameters of inflammation. Sonography suggested the presence of an echinococcal cyst in segment VIII of the liver. Computed tomography confirmed this finding and showed no other cysts. On the basis of serological tests and the clinical findings, a diagnosis of Echinococcus granulosus infection was made. The patient was therefore admitted to hospital for surgical removal of the cyst. Her postoperative recovery was without complication and she remained free of symptoms.


CONCLUSIONS
Echinococcus granulosus infections are rare in Germany, with an incidence of 1:1,000,000. The sonographic appearances are generally characteristic and permit diagnosis. Treatment is pharmacological (albendazole, mebendazole) and surgical. It is curative in the vast majority of cases. The possibility of echinococcal infection should be considered in patients, especially immigrants, with abdominal pain.
Frese
Thomas
T
Department of Primary Care of the Leipzig Medical School, Philipp-Rosenthal-Strasse 55, 04103 Leipzig, Germany.
Jonas
Sven
S
Sandholzer
Hagen
H