Hydatid disease of sigmoid colon

A 57 years old man presented with right loin pain and bouts of diarrhea. Plain x-ray of the abdomen revealed two calcified masses, one in the right hypochondrium and the other one in the pelvis, the diagnosis was that of calcified hydatid cysts [fig. 1]. Ultra sound examination revealed that the calcified mass in right hypochondrium was located in the liver, while the other pelvic mass was not related to any organ, it was located posterior and superior to the urinary bladder in relation to an air filled bowel loop [sigmoid colon]. The patient refused further investigations, he used an antidiarrheal locally grown plant named [shandagura]. Two weeks later he came back claiming that he had passed out a small hard piece with stools. Plain x-ray of abdomen showed that the pelvic calcified mass was broken and two pieces were been in the pelvic cavity [fig. 2]. One day later, the patient passed out another piece confirmed by plain way of the abdomen [fig. 3]. Another day passed and the last piece was expelled out [fig. 4]. The two calcified pieces that had passed out with stools are shown in [fig. 5]. Three months later the patient showed up for follow up, plain abdomen showed same findings of calcified mass in right hypochondrium and no pelvic calcifications. C.T. of the abdomen was done and the findings were consistent with calcified hepatic hydatid cyst [fig. 6]