OPEN ACCESS Anaphylactic Shock Diagnosed with Bedside Abdominal Ultrasonography and Com- puterized Tomography AMansur Kürşad Erkuran 1 , Serhat İldeş 1 , Arif Duran 1* , Tarık Ocak 2 1 Abant Izzet Baysal University, İzzet Baysal Training and Research Hospital Emergency Medical Training Clinic, Bolu/TURKEY 2 İstanbul Kanuni Sultan Süleyman Training and Research Hospital Emergency Medical Training Clinic, İstanbul/ TURKEY *Corresponding author: Dr. Arif Duran MD, Associate Professor in Emergency Medicine, Abant Izzet Baysal University Medical Faculty, Department of Emergency Medicine, 14280 Golkoy – BOLU, TURKEY, Tel: +90 374 2534656; Fax: +90 374 2534615; Email:drarifduran@gmail.com Received: 02-19-2016 Accepted: 04-19-2016 Published: 04-23-2016 Copyright: © 2016 Arif Duran Case Report Cite this article: Arif Duran. Anaphylactic Shock Diagnosed with Bedside Abdominal Ultrasonography and Computerized Tomography.J J Emergency Med. 2016, 3(2): 029. Highlights 1. Patients with hydatic cyst rupture may present with atypical anaphylactic shock signs such as pruritus, dyspnea and fatigue in endemic areas. 2. If bedside ultrasonography of the liver in such patients indicates cysts, immediate anaphylaxis treatment with epinephrine is recommended. Second line therapies should also be given. 3. Best diagnostic approach is abdominal computerized tomography. Abstract Aim: A comatose patient otherwise normal with no clues of medical history is a predicament not easy to solve. Focused abdom- inal sonography in trauma (FAST) may also help physicians to guide the diagnosis in cases of severe shock with unknown cause. Case: Here, we present a 29-year-old man with no known medical history who was brought to our emergency department (ED) intubated due to unconsciousness, hypotension, severe dyspnea and pruritus. On arrival to our ED, his pulse was filiform, and his extremities were cold and cyanotic. FAST examination to rule out trauma showed anechoic cysts in liver. His abdominal CT revealed ruptured pouch of a hydatic cyst. He was hospitalized in ICU and in the surgery clinics for four and two days after sur- gery, respectively. He was discharged with full recovery. Conclusion: when patients with severe shock signs admit EDs in areas where animal husbandry is common, anaphylaxis due to hydatic cyst rupture should be kept in mind. FAST and ensuing CT can give clues about cysts in the liver. Keywords: Anaphylactic Shock; Severe Dyspnea; Hydatic Cyst Rupture Introduction A comatose patient otherwise normal with no clues of medi- cal history is a predicament not easy to solve. A wide range of diseases including severe infections, intracranial pathologies, drug overdose and many other shock reasons should be ruled out. Focused abdominal sonography in trauma (FAST) has settled down as a routine emergency practice. However, it may also help physicians to guide the diagnosis in cases of severe shock with unknown cause. Here, we present a 29-year-old man with no known medi- cal history who was brought to our emergency department (ED) intubated due to unconsciousness, hypotension, severe Jacobs Journal of Emergency Medicine