Management of intact and ruptured pulmonary hydatid cysts

Tunisia is an endemic area for lung hydatidosis. The clinical presentation depends on whether the cyst is intact or ruptured. We aimed to compare the clinical and therapeutic features between intact and ruptured hydatid cysts of the lung.Between January 2014 and December 2017, 152 patients were managed for a lung hydatid disease in the thoracic surgery department of Abderrahmen Mami hospital. A retrospective analysis was performed and the patients were divided into two groups based on whether the hydatid cyst was intact (group 1, n=43) or ruptured (group 2, n=109).The median age was 36 years old[5-84years]. Reported complications were:infection(50%), rupture of hydatid cyst in the bronchi(40%) and rupture in the pleura(10%). Multiple hydatidosis was reported in 30 patients(19.7%), associated with a hydatid pulmonary embolism in 3 patients. Chest pain was more frequent incase of an intact cysts(79%versus49%, p<0,001). In patients with complicated cysts, symptoms were dominated by hemoptysis(49%)and hydatid vomica(17%). Chest CT scan was more required in the second group(95% versus 69%).A video-assisted thoracoscopic approach was more indicated in the group with intact cysts(46.5%versus41.2%, p=0.55). The most often performed surgical procedure was cystectomy in both groups. Lobectomy was necessary for 14patients(12.8%) with ruptured cysts versus 4patients(9.3%) with intact cysts(p=0.54). There were no significant differences between the two groups in hospital stay and in po...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric respiratory epidemiology Source Type: research