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Received Nov 5, 2017; Accepted Feb 5, 2018
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1. Introduction
Renovascular hypertension is an unusual but treatable cause of refractory hypertension that is infrequently caused by compression of the renal vasculature by a giant hydatid cyst. Cystic echinococcosis (CE) is a parasitic illness caused by infection with Echinococcus granulosus (E. granulosus) in its larval stage [1]. The tapeworm stage is harbored in the intestine of carnivores such as dogs, which constitute the definitive host [2], and the eggs are passed in the feces of the infected carnivores and ingested by herbivores such as sheep, which comprise the intermediate host. Humans are the incidental intermediate host.
Larvae emerge from the eggs in the intestine, and after invasion to the blood vessels, they can migrate into almost every part of the body [3]. The most common site is the liver.
Large cysts, today fairly rare even in endemic areas, are called giant hydatid cysts (GHCs) [4, 5]. Hepatic hydatid cysts may show growth either in the liver capsule, gastrohepatic ligament, or peritoneum. Giant cyst as seen in our patient enlarging through the peritoneum may cause rare symptoms because of the intra-abdominal mass effect.
2. Case Presentation
A 24-year-old native Arabian lady, mother of four, from the high mountainous area who was managed by a local primary healthcare centre as a case of essential hypertension, was referred to the medical outpatient department of our secondary care facility for uncontrolled hypertension for the last few months. After primary assessment, the medical team put her on antihypertensive...