Isolated peritoneal involvement as a primary manifestation of cystic echinococcosis

A 33-year-old, previously healthy, man was admitted with acute abdominal pain, vomiting, and diarrhoea. Blood samples showed elevated inflammation parameters (leukocytes 18·21 G/L [normal range 4·0–10·0 G/L] and C-reactive protein 158·0 mg/L [normal range 0·0–5·0 mg/L]). CT scans revealed an accentuated appendix, moderate ascites (despite unremarkable liver anatomy), and four partially cystic and calcified lesions of unknown origin in the lower abdomen—the largest measuring 60 mm in diameter.