Abstract

The clinical finding, diagnosis and outcome of patients with complicated lung hydatid cysts

Author(s):Mohammad Reza Asgary, Manouchehr Aghajanzadeh, Hosein Hemmati, F. Safarpoor, Ali Alavi and Hosein Amani

Rupture of a hydatid cyst may cause some unique problems in children and adult .The clinical presentation and the preoperative diagnosis and postoperative complications depend on whether the cyst is intact or ruptured. The aim of this study was to review the problems of the ruptured pulmonary hydatid cysts. Between 1996 and 2009, 58 patients with a total of 74 ruptured lung hydatid cysts were operated. The medical records for 58 patients of pulmonary hydatidosis were retrospectively investigated. Data related to symptoms, preoperative diagnosis and complications, surgical procedures, postoperative morbidity, hospitalization time, and cyst recurrence were collected. 42 patients (72.41%) were male. the median age of patients was 32 years (range, 4 to 69 years). Clinical symptoms were as follow: Productive cough in 47 patients (81%), Dyspnea in 42 patients (72.41%), chest pain in 31 patients (53.44%) and hemoptysis in 13 patients (22.41%). Assessment of clinical findings, chest roentgenograms, thoracic computed tomography, led to the correct preoperative diagnosis of pulmonary hydatid disease in 52 patients (89.65%). Right lower lobe was the most common location of cyst in the lungs (63%). In 42 cases (72.41%) rupture of cyst occurred into tracheobronchial tree and in 10 patients (17.24%) rupture of cyst occurred into pleural space. recurrent pneumonia occurred in 6 patients (10.34%). Postoperative complication was occurred in 20 patients (34.48%). Reoperation performed for bronchopleural fistula in 2 patients and bilo-pleural fistula in 1 patient. Recurrence occurred in 1 patient which treated with albendazol. Hospital mortality was not occurred. Surgery is the primary mode of treatment for patients with pulmonary hydatid disease. Complicated cases have higher rates of preoperative and postoperative complications and require longer hospitalization time and more extensive surgical procedures. Immediate treatment should be performed in any patient who is diagnosed with pulmonary hydatid cysts.

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