[Pulmonary embolism and anaphylactic shock caused by rupture of a hepatic hydatid cyst]

A 44 year old man was admitted to hospital as an emergency for shock associated with giant urticaria and atrial fibrillation. Angiography showed pulmonary embolism, and an image suggesting a hydatid cyst of the liver was observed by echocardiography in the sub-costal view, confirmed by liver ultrasonic scan and serology. After treatment with Albendazole, the cyst was removed surgically and histology showed the characteristic appearances of hydatid disease. The final diagnosis was rupture of a hydatid cyst into a sub-hepatic vein with anaphylactic shock and pulmonary embolism.