CASE the dimensions 120 x 15 mm. According finding


A 77-years-old men with lower left abdominal quadrant pain and tenesmus was referred to the department of surgery at Marand hospital. Patient was residing
in the village of Dizaj around of Marand County (38°25?58?N 45°46?30?E), East
Azerbaijan Province Iran. On physical and clinical examinations
had nausea, vomiting, abdominal pain, diarrhea, without conversion and frequent
urination from 15 years that the last four months had more problems was
reported. He had history of dog and soil contact. In laboratory examinations,
the rate of WBC 19400, Platelets 189,000, RBC 5.21, SCOT, and SGPT were 41 and
81, respectively. The total bilirubin 32.1 and direct bilirubin was 0.73.  Hematocrit 6.8%, hemoglobin 13 and level of
sodium low reported. Ultrasonography of the patient abdomen showed a cyst with heterogeneous mass in the back
of the urinary bladder neck between the umbilical region and external urethral
sphincter in the dimensions 120 x 15 mm. According finding 50×35 mm unilocular
cystic mass with regular borders in eight segment adhere to the upper part of
the spleen and a cyst with size of 10×8 mm calcified in the right part of the
liver (Figure
1). The patient was candidate for open-abdomen
surgery during the operation, a 12-cm long, uniloculated white cyst containing
an opalescent fluid was detected inside the umbilical region and external
urethral sphincter of urinary bladder neck was observed. Left hepatic cyst and
cyst of behind the bladder was resection and no prostate hyperplasia was
observed during surgery. The right hepatic hydatid cyst was drainage. The
isolated hydatid cysts was referred
to the pathology laboratory and the tissue sections were stained with two
staining method and Tri-chrome. Microscopic examination of prepared tissue
sections showed protoscoleces of E. granulosus with thin laminated
hyaline layer and a granular germinal layer, which revealed the diagnosis of a
hydatid cyst (Figure 2). In
patients follow-up, frequent urination problems were improved, which
Pollakiuria could be related to the effects of the bladder cyst. For treatment,
Ciprofloxacin 500 mg every 12 hours. Albendazole 400 mg daily and used Mebendazole
100 mg daily for 6 months, plus Sonography was recommended one month later. The patient recovered after the surgery with a good general
condition discharged from hospital.

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