A GIANT RUPTURED HYDATID CYST CAUSING TENSION PNEUMOTHORAX AND HEMOTHORAX IN A PATIENT WITH BLUNT THORACIC TRAUMA: A RARE CASE ENCOUNTERED IN THE EMERGENCY CLINIC

A 26-year-old male farmer presented to the Emergency Department (ED) complaining of left-sided chest pain and increasing dyspnea after blunt trauma involving cattle 6 h prior. He had a productive cough and expectorated slightly salty fluid. On the physical examination, the blood pressure was 90/60 mm Hg, pulse rate was 129 beats/min, and the respiration rate was 27 breaths/min. The left side of the chest did not fully expand with inspiration. Breath sounds were diminished on the left side. The laboratory results were non-specific. A posterioranterior view of the chest (Figure 1) revealed a 10 8-cm air cyst located on the diaphragm in the left hemithorax, a pleural effusion in the left costophrenic angle, deviation of the heart to the right, and a parenchymal consolidation. The initial diagnosis of the patient, who had a history of trauma, was traumatic hydropneumothorax based on the findings revealed by the pulmonary graph. However, the findings were not typical for a traumatic hydropneumothorax, and salty fluid expectoration as described by the patient was suggestive of other possible diagnoses. The computed tomography (CT) scan of the chest revealed a ruptured cyst measuring 16 12 11 cm in the left hemithorax, in the base of which a germinative