Anaphylactic shock as a single presentation of Echinococcus cyst

We describe the case of a 14-year-old boy of Turkish origin, pre- senting with anaphylactic shock after a minor abdominal trauma. Further investigations revealed a hepatic Echinococcal cyst with- out evidence of rupture. Anti-helminthic therapy was adminis- tered. Because of aggravating symptoms and recurrent anaphylax- is, surgical excision was performed. Intra-operative, a rupture into the biliary tree was seen. After surgery, the anaphylactic symptoms disappeared and the patient recovered. This case-report supports the fact that anaphylactic shock can be the only presentation of a hydatid cyst. Microscopic spillage can possibly be sufficient to cause major anaphylaxis. (Acta gastroenterol. belg., 2011, 74, 462- 464).