Pulmonary hydatid cyst mimicking pneumonia, lung mass, pneumothorax, pleural effusion, pulmonary abscess, and pyopneumothorax
Keywords:
echinococcosis granulosus, hydatid cyst, pulmonary hydatid cystAbstract
The lung is the second most common site of involvement with echinococcosis granulosus in adults after the liver (10-30% of cases), and the most common site in children. Rupture of a pulmonary hydatid cyst (PHC) may cause some unique presentations in these patients .The clinical presentation and complications of PHC depend on whether the cyst is intact or complicated. Presentations of the complicated PHC group are unusual such as: mass, pneumonia, pleural effusion, pulmonary abscess, and pneumothorax .The aim of this study was to review the problems of the complicated PHC ones. Between 2002 and 2021, 59 patients with a total of 82 ruptured PHC were gone under the operation. The medical records for 59 patients of pulmonary hydatidosis were retrospectively investigated. Data related to symptoms, preoperative diagnosis, surgical procedures, postoperative morbidity, hospital stay were gathered. Among these patients, 36 patients (61%) were male. The median age of the patients was 36 years (range, 12 to 60 years). The clinical manifestations were as follow: Productive cough in 15 patients (25.42%), Dyspnea in 14 patients (23.72%), chest pain in 22 patients (37.28%), fever in 12 patients (20.33%), and hemoptysis in 11 patients (18.64%). Preoperative tools for diagnosis were: chest X-ray, Thoracic Computed Tomography(CT-scan), and Magnetic Resonance Imaging (MRI) which led to the correct preoperative diagnosis of complicated pulmonary hydatid disease in 22 patients (37.28%). Right lower lobe was the most common location of these cyst in the lungs in 37 patients (63%). In 39 cases (66.10%) rupture of cyst occurred into tracheobronchial tree, while in 20 patients (33.89%) rupture of cyst occurred into pleural space. Furthermore, recurrent pneumonia occurred in 11 patients (18.64%). Also lung abscess were observed in 11 patients and lung mass in 17 patients. Postoperative complications were occurred in 18 patients (30.50%). Reoperation performed for bronchopleural fistula in 5 patients. Median hospital stay for the patients was 10 days.
Surgery is the primary mode of treatment for patients with complicated cases of pulmonary hydatid cyst. Immediate treatment should be performed in any patient who is diagnosed with pulmonary hydatid cyst because any delay in the treatment will increase morbidity, mortality, and hospital stay.
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Copyright (c) 2022 Ehsan Hajipour Jafroudi, Manouchehr Aghajanzadeh, Ali Alavi Foumani, Azita Tangestaninejad, Yousha Pourahmadi, Mahsa Mousazadeh
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