A Patient Presenting with Abdominal Pain to the General Practitioner: A Case Report

Thomas Frese; Sven Jonas; Hagen Sandholzer


Cases J. 2009;2(1):9297 

In This Article

Abstract and Introduction


Introduction: Right-sided upper abdominal pain is a common cause of presentation to general practitioners.
Case presentation: An otherwise well 46-year-old woman presented to her general practitioner with intermittent abdominal pain that had been present for several months. The only abnormality found at the initial consultation was moderate tenderness in the right upper abdomen. The laboratory tests that were ordered showed elevated parameters of inflammation. Sonography suggested the presence of an echinococcal cyst in segment VIII of the liver. Computed tomography confirmed this finding and showed no other cysts. On the basis of serological tests and the clinical findings, a diagnosis of Echinococcus granulosus infection was made. The patient was therefore admitted to hospital for surgical removal of the cyst. Her postoperative recovery was without complication and she remained free of symptoms.
Conclusion: Echinococcus granulosus infections are rare in Germany, with an incidence of 1:1,000,000. The sonographic appearances are generally characteristic and permit diagnosis. Treatment is pharmacological (albendazole, mebendazole) and surgical. It is curative in the vast majority of cases. The possibility of echinococcal infection should be considered in patients, especially immigrants, with abdominal pain.


Abdominal pain is a common cause of presentation to general practitioners. According to data from Part 2 of the Sächsische Epidemiologische Studie in der Allgemeinmedizin (Saxon epidemiological study in general practice; SESAM-2), abdominal pain accounts for 4.2% of visits to general practitioners. The present case report refers to a cause of abdominal pain which, though relatively rare, must be considered by general practitioners in the differential diagnosis of abdominal pain.


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