Pulmonary embolism and anaphylactic shock due to rupture of a hepatic hydatid cyst.

A 44 year old man was admitted to hospital as an emergency for shock associ ated with giant urticaria and atrial fibrillation. Angiography showed pulmo nary embolism, and an image suggesting a hydatid cyst of the liver was obse rved by echocardiography in the sub-costal view, confirmed by liver ultraso nic scan and serology. After treatment with Albendazole, the cyst was remov ed surgically and histology showed the characteristic appearances of hydati d disease. The final diagnosis was rupture of a hydatid cyst into a sub-hepatic vein w ith anaphylactic shock and pulmonary embolism.