Complicated Hydatid Cyst Research Articles

Predictive Factors of Pulmonary Hydatid Complications in Children

BackgroundPulmonary echinococcosis in children has frequent and severe complications. The aim of our study was to determine predictive factors of pre and postoperative complications of pediatric pulmonary hydatid cyst. MethodsWe conducted a retrospective descriptive and analytic study conducted from January 2010 to December 2018. The study population was divided into two groups to determine predictive factors of pre- and post-operative complications of pediatric pulmonary echinococcosis. Data were analyzed by IBM SPSS 21.0. A p-value of 0.05 was accepted as significant. ResultsThe study included 106 boys and 94 girls with a median age of 8 years. One hundred and thirty-eight patients (69%) had complicated pulmonary hydatid cyst preoperatively. Univariate analysis identified 12 predictive factors of pre-operative complications: rural origin (p = 0.0001), hydatid contact (p < 0.001), long period between the onset of symptoms and the first medical consultation (p = 0.0001), the autumn and the winter (cold seasons) (p = 0.0001), chest pain (p = 0.0001), hemoptysis (p = 0.023), fever (p = 0.0001), right side (p = 0.01), apical and para hilar location (p = 0.01), superior lobe (p = 0.05), superior right lobe (p = 0.0001), cyst size>5 cm (p = 0.02), positive hydatid serology (p < 0.0001). It identified 2 predictive factors of post-operative complications: giant cyst (p = 0.009) and not performing a capitonnage (p = 0.016). Multivariate analysis showed 4 independent pre-operative predictive factors of complications: rural area (p < 0.0001), fever (p = 0.006), right side (p = 0.02) and positive hydatid serology (p < 0.001). It identified 2 postoperative independent predictive factors of complications: not performing. capitonnage (p = 0.029) and solitary hydatid pulmonary cyst (p = 0.02). ConclusionPulmonary hydatid cyst management in children needs a thorough appreciation of independent predictive factors of pre and postoperative complications in order to reduce their morbidity.

Surgical Management for Complicated Hydatid Cyst of the Lung about 94 Cases

Introduction: Pulmonary hydatid disease is a parasitic infestation endemic in many sheep and cattle farming regions, particularly in Algeria. Complicated forms are a frequent occurrence and characterized by radio-clinical polymorphism and therapeutic difficulties. Material and Methods: This is a retrospective study (2017—2023) including 94 cases of complicated hydatid cyst of lung. Results: Complicated hydatid cyst of lung represented 22.76% of all hydatid cyst of lung treated surgically in our department. The average age was 27.8 years (4—56 years) with a slight male predominance 57.45%. The circumstances of discovery were dominated by cough in 54.26% and hemoptysis in 32.99%. The definitive diagnosis was made on the radio-clinical and biological findings. The treatment was surgical in all cases, conservative treatment was practiced in 87.03%, and parenchymal resection was performed in 16 patients. Postoperative hydatid recurrence was noted in only one patient. Conclusion: Hydatid cyst of the lung is a common zoonosis in Algeria. Its treatment is essentially surgical and must be initiated quickly once the diagnosis is established in order to avoid progression towards complications that are sources of diagnostic and therapeutic difficulties.

Presentation, diagnosis, management and outcome of complicated hydatid cyst of the lung

Introduction: Introduction: The complicated hydatid cyst of the lung is defined as any cyst ruptured in the bronchi tree or in the pleural cavity, infected, and rarely in the pericardial cavity. The aim of this study was to evaluate the problems of complicated pulmonary hydatid cyst, including presentation, diagnosis choice of surgical methods. and complication of delay in surgical treatment of pulmonary hydatid cysts. Methods: Between 2016 and 2021, 192 operations operated for pulmonary hydatid cysts, 42 of these patients were complicated hydatid cyst. Presentations were cough, chest pain and dyspnea.Diagnosis tools were CXR and CT-scan of chest. surgical approach was a posterolateral thoracotomy and anterolateral thoracotomyin all patients; a phrenotomy in eight patients and one-stage bilateral thoracotomy in six patients. Results: In 18 patients (67.5%), there were single hydatid cysts; whereas 4 patients (32.5%) had multiple cysts.12 patients had bilateral cyst and 8 had both lung and liver and others organs, 6 patients had preoperative hydatid cyst history. Iatrogenic rupture of an intact hydatid cyst occurred in 4 patients. Extrathoracic involvement was apparent in 6 patients (27%). Intrathoracic but extrapulmonary involvement was apparent in 4 patients (16%). Conclusion: Complicated hydatid cyst may present with different clinical and radiologically manifestations as a primary lung tumor , pleural effusion ,empyema hydropneumothorax. In patients with suspicious lung masses in endemic area or history of a hydatid cyst in patients a complicated pulmonary hydatid cyst may be in differential diagnosis.

Pyopneumothorax revealing a complicated hydatid cyst of the lung

Pulmonary hydatidosis remains asymptomatic for a long time, and may be revealed following a complication such as intrapleural rupture. This entity, known as pyopneumothorax, poses a diagnostic problem even in countries with high hydatid endemicity. The aim of this study was to investigate the clinical, radiological and therapeutic aspects of pulmonary hydatid cysts revealed by spontaneous pyopneumothorax. This is a retrospective descriptive study of 5 patients with spontaneous pyopneumothorax revealing complicated pulmonary hydatidosis collected over 8 years at the Pneumology Department, CHU Mohamed VI, Marrakech, Morocco. Patients were younger and male. Clinical signs were dominated by cough and fever. Chest X-ray showed a hydroaeric image. Pleural puncture revealed a purulent fluid. Direct examination and culture of this fluid did not isolate any germs. All patients were drained and put on initial probabilistic antibiotic therapy. In view of the lack of clinical, biological and radiological improvement and the clinical presentation, we suspected complicated pulmonary hydatidosis. CT scan and thoracic ultrasound confirmed the diagnosis of ruptured KHP.

Hirurško lečenje komplikovane hidatidoze ductus choledochus-a tokom pandemije COVID-19 - efikasnost i ograničenja radiološke službe i hirurgije u vanrednim uslovima

Introduction: While uncomplicated echi-nococcal cysts can grow in the liver for years without symptoms, complicated hydatid cysts (CHC) present distinct clinical characteristics that necessitate urgent treatment. Case Report: We present a case of acute biliary obstruction, cholangitis, and sepsis due to massive cho-ledocho-hydatididosis in an 84-year-old COVID-positive patient during the COVID-19 pandemic. Imaging revealed a multicystic lesion in liver segments V and VIII that compressed surrounding liver tissue, leading to intrahepatic duct dilation. A daughter cyst in the ductus choledochus was confirmed during surgery. An attempt at endoscopic retrograde cholangiopancrea-tography (ERCP) was unsuccessful. We performed an open pericystectomy with total cystectomy and choled-ochotomy, carefully evacuating all hydatid cysts. The postoperative course was uneventful, and the patient was discharged without surgical complications. Conclusion: Complicated hydatid cysts (CHC) leading to acute biliary obstruction require prompt diagnosis and indicate the need for rapid evacuation of the cyst and correction of complications.

Ruptured Pulmonary Hydatid Cyst with Multiple Small Bronchopleural Fistula Formations: A Case Report

Hydatid disease is a zoonosis caused by Echinococcus granulosus. It manifests as cystic lesions, most commonly found in the liver and lungs, and rarely in other parts of the body. The disease occurs when a human host accidentally ingests contaminated food containing eggs from canine waste products. Since the clinical characteristics of this disease are nonspecific, radiological investigations play a crucial role in diagnosis. Diagnostic challenges arise due to atypical imaging features of complicated hydatid cysts. A 40-year-old female patient presented with fever, breathlessness, chest pain, and an unproductive cough persisting for eight days. Upon examination, she was in hypovolaemic shock, and an intercostal drainage tube had been inserted in the left sixth intercostal space. The chest radiograph revealed a dense, homogeneous opacity in the left hemithorax, partially compressing the left lung medially. An High-resolution Computed Tomography (HRCT) thorax showed a thick-walled cavity with an air-fluid level and layered membranes in the dependent part of the cavity, indicating a water lily sign in the left lower lobe of the lung, suggesting a ruptured hydatid cyst. The patient underwent cystectomy with suturing of a small bronchopleural fistula. Computed Tomography (CT) is the preferred imaging modality, especially for assessing associated complications and ruling out differentials in cases of ruptured pulmonary hydatid cysts.

Presentations, diagnosis, treatment and outcome of complicated liver hydatid cysts: from an endemic area

Background: Hydatid cysts (HC) can involve all organs of the human body but most often in the liver (77% to 50%) and lungs (35%18%). (HC) is endemic in certain areas of the world as in the Middle and Far East, Iran, Australia, New Zealand, and South America. (HC) remains a considerable public health problem. Methods: In a retrospective study was carried out in north of Iran Guilan Provence. A total of 322 patients who were operated on for 382 (HC in the liver between 2016 to 2020 were evaluated. Patients were divided in tow group complicated (HC) in 87 patients and uncomplicated (HC) in 235 patients.frank intra-abdominal in 15 and frank Intrabiliary rupture in 14, occult Intrabiliary rupture in 32, cyst infection in15, intrapleural and intraparachimal rupturein 10 patients. Results: The patient’s gender included 72% were men and 28% were women with a median age of 18 to 64 years. Abdominal ultrasound, computed tomography, MRCPand ERCP were the diagnosis tools. In interapleural or intraparachymal rupture thoracotomy and laparotomy performed with evacuatin and omentoplaty, capitonnage and decortication.in trapricardial rupture thoracoyomr and pricadiotomy and laparotomy and omentoplasry, pricystectomy or capitonnage was performed There was one mortality. The postoperative morbidity was in 28 patients in complicated cysts and 12 in uncomplicated cysts. Conclusion: Complicated hydatid cyst of the liver can be successfully managed surgically with good long-term results. Complicated liver echinococcosis demonstrates several distinct features that differentiate it from the noncomplicated disease. Frequently severe clinical manifestations, complexity of surgical management, and the increased postoperative complications characterize complicated liver echinococcal disease

A life-threatening encounter: an uncommon case of ruptured hydatid cyst presenting as anaphylactic shock and respiratory distress in a 12-year-old boy

Introduction and importance: Although rare, the spontaneous rupture of a lung hydatid cyst or its perforation into the pleural cavity can give rise to an abrupt onset of symptoms, including cough, fever, hemoptysis (coughing up blood), and hypersensitivity reactions, and can ultimately lead to respiratory failure. Case presentation: A 12-year-old boy was brought to the emergency room with a loss of consciousness. Symptoms included tachypnea, fever, low blood pressure, and overall respiratory distress. After resuscitation, a chest X-ray revealed a distinct, well-defined round opacity located in the lower region of the right lung, leading to mediastinal displacement. After confirmation of the disease, the child was hospitalized in the ICU care and consequently underwent surgery. Treatment was successful and there was no recurrence on the follow-up. Clinical discussion: Studies have demonstrated that the right lower lobe of the lung is the most frequently affected area of the lung by hydatid cysts. Symptomatic and complicated hydatid cysts are a rare concept in children, and only a small percentage, are diagnosed in patients younger than 16 years. Surgery remains the preferred treatment for the majority of patients with pulmonary hydatid disease. It is important to note that combined surgery and chemotherapy represents the current gold standard in managing pulmonary hydatid cyst. Conclusion: Although anaphylactic shock caused by a ruptured lung hydatid cyst is rare, it should be taken into consideration by physicians as a differential diagnosis in patients who also have respiratory symptoms, particularly in endemic areas.

Early postoperative intra-axial dissemination of a pediatric extradural and complicated hydatid cyst.

Hydatid disease is very common around the Mediterranean basin and endemic in some parts of the world. Cerebral involvement remains rare, represents only about 2% of all hydatid localizations and mainly affects the pediatric population. Extradural hydatid cyst is very rare or even exceptional when it is associated with or followed by intracerebral disseminations. Here, the authors report a new exceptional case of an early multiple intra-axial hydatid dissemination in a 5-year-old North African male patient from a rural area who underwent surgery 3months after a primary osteolytic extradural and complicated hydatid cyst with good clinical and radiological outcomes.

Role of conservative therapy in complicated giant pulmonary hydatid cyst cases

Role of conservative therapy in complicated giant pulmonary hydatid cyst cases

“Air Bubble Sign” and Fibreoptic Bronchoscopy in Complicated Pulmonary Hydatid Cysts: Steps in the Right Direction

“Air Bubble Sign” and Fibreoptic Bronchoscopy in Complicated Pulmonary Hydatid Cysts: Steps in the Right Direction

Cough, with a sac of marbles in the chest.

A 48-year-old male patient presented with productive cough, dyspnea and abdominal pain of 2 months duration. He was diagnosed with diabetes mellitus 6 months ago and had not been regular with his medications. Clinical examination revealed a respiratory rate of 18 per min with room air saturation of 95%, and a paucity of movements with bronchial breath sounds identified on inspection and auscultation, respectively, over the right hemithorax. Chest skiagram and computed tomography images of his thorax are shown below [Figure 1].Figure 1: (a) shows chest skiagram and (b–d) shows high-resolution computed tomography images of the chest. A description of the images is in the accompanying textQuestion: What is the diagnosis? Answer: Pulmonary and hepatic hydatid disease. DISCUSSION The chest skiagram [Figure 1a] revealed a well-defined round radio-opacity in the right mid zone with a crescentic hyperlucent medial margin, called the crescent sign (white arrow). Figure 1b is a coronal view of high-resolution computed tomography (HRCT) scan of the chest lung window, which shows a large cyst in the right lung, with multiple small rounded opacities with fluid attenuation, some of which appear to be floating within it, appearing like a sac of marbles. This is consistent with a diagnosis of a hydatid cyst with multiple daughter cysts within it. There are pockets of air seen between the outer pericyst and inner endocyst, aptly named ‘air-crescent sign’ (blue arrow) and ‘signet ring sign’ (red arrow), which suggest a ruptured or complicated hydatid cyst. Figure 1c, the sagittal section of the HRCT scan of the chest lung window at the level of the aortic outflow tract, shows the ruptured hydatid cyst in the right lung. The daughter cysts have collected in the dependent area of the larger cyst, with some appearing to ‘rise’ over the rest, or the ‘rising-sun sign’ (blue arrow). Also seen is a small air pocket inferiorly (red arrow) between the pericyst and endocyst, called the ‘air-bubble sign’. The presence of air on either side of the endocyst (red arrowheads) gives the appearance of an ‘onion-peel sign’, or the ‘cumbo sign’. Figure 1d shows a large well-defined homogenous cyst in the right lobe of the liver.[1] Blood investigations revealed uncontrolled blood sugar levels. Armed with the characteristic radiology above, and supplemented by a positive serum latex agglutination test for Echinococcus antigen, he was diagnosed with pulmonary and hepatic hydatid disease. He was started on oral albendazole and subsequently underwent pericystectomy of lung cyst along with partial pericystectomy of cyst in the liver. Post-surgery, he is at present asymptomatic and is on regular follow-up. Hydatid disease is a zoonosis, commonly caused by the accidental ingestion of ova of the tapeworm Echinococcusgranulosus, which subsequently develop into larvae in the host intestine and migrate to other parts of the body where they develop into embryos, with the liver and lung being the most commonly involved organs.[1] Characteristic thoracic radiology should lead clinicians to suspect pulmonary hydatid disease, especially when dealing with patients with non-resolving pneumonia or lung mass. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Organizing pneumonia: a rare complication of a complicated pulmonary hydatid cyst.

Organizing pneumonia: a rare complication of a complicated pulmonary hydatid cyst.

Kist hidatiğin nadir prezantasyonu: hepatik arter psödoanevrizma kanaması ve senkron duodenal fistül

Aims: Hydatid cyst disease is a rare cause of upper gastrointestinal bleeding. Peculiarly if it's resulted from a ruptured hepatic artery aneurysm in the hydatid cyst cavity which is fistulated into the duodenum. We here present a case of hepatic artery pseudoaneurysm due to a complicated hydatid cyst with synchronous duodenal fistula. &#x0D; &#x0D; Case: A 45-year-old male was admitted to the emergency department with hematemesis and hematochezia. The patient had a history of a hydatid cyst of liver and a surgical procedure of lung ecinoccosis. Endoscopy revealed an unusual ulcerated lesion in the duodenum. Yellow membranes were observed in the midst and blood oozing. After unsuccessful endoscopic sclerotherapy, a Computerized Tomography (CT) was performed. CT revealed a ruptured hydatid cyst into the duodenum and bleeding from the formed hepatic artery pseudoaneurysm. Hepatic artery coil embolization was performed urgently and a percutaneous transhepatic drainage catheter was applied to maintain the bile flow. Subsequently, a 10 Fr , 10 cm plastic stent was inserted via Endoscopic Retrograde Cholangiopancreatography (ERCP). The rare complication which was observed after embolization was the hepatic abscess. Although a percutaneous catheter was inserted initially, drainage wasn’t successful. As a last option, surgical debridement was considered.&#x0D; &#x0D; Conclusion: If a patient who presented with upper gastrointestinal bleeding with a previous history of liver hydatid cyst, cyst complications must be listed as a differential diagnosis. Besides endoscopy, contrast-enhanced CT and ЕRCP are the essential diagnostic and therapeutic approaches.

Water lily appearance synonymous with hydatid cyst

The water lily appearance corresponds to the presence of wavy or serpiginous structures within an excavated mass. It indicates the presence of a complicated hydatid cyst. Hydatid cyst is a cosmopolitan anthropozoonosis, related to the development of a larval form of a parasite "echinococcus granulosis". The pulmonary localization comes in second place after the hepatic one [1]. From an anatomical point of view, a hydatid cyst appears to be made up of a reactionary tissue membrane belonging to the host and two other membranes, constituents of the parasite; one is acellular (anhistic cuticle) whereas the second, the germinative proliga, gives rise to daughter vesicles. It contains hydatid fluid in rock water containing numerous protoscolex and membrane debris known as hydatid sand [2]. It is suspected in the presence of hemoptysis, rejection of membranes, hydatid vomitus or non-specific respiratory symptoms concomitant with a particular context in this case when contact with dogs, which are the definitive hosts, is found. Its diagnosis is made possible by imaging through chest X-ray and thoracic CT, which are by far the most used means. Thus, different aspects of hydatid cysts are found on imaging, depending on the stage of evolution: it may be a simple cyst (unilocular cyst), identified as a low-toned, watery, well-limited, homogeneous opacity, known as a cannonball; corresponding to a mass of liquid density with a thin, regular wall on CT; or a complicated cyst (fissuring, rupture, compression). In the case of rupture, the hydatid cyst appears as a hydroaerobic image with an undulating border, describing serpentine structures, reminiscent of a "water lily" flower [1]. This sign is of great help in the etiological research in front of a hydro-pneumothorax of great abundance, thus implying a surgical management.

Surgical treatment of liver hydatic cyst and evaluation of cystobiliary fistula: experience of two centers

Objective: Intrabiliary rupture or cystobiliary fistula is the most common complication of hepatic hydatid cyst. In this article, our objective is to evaluate the clinical, laboratory, imaging, surgical treatment and results of cystobiliary fistulas, which is the most common complication of hydatid cysts. Material and Method: In our study, patients who underwent open surgery and were followed up and treated for hydatid cyst in the gastroenterology and general surgery outpatient clinic and service between years 2015-2021 were included. The clinical, laboratory, radiological and surgical results of 171 patients with hydatid cysts were retrospectively analyzed. Results: The mean age of 171 patients who underwent surgery for hydatid cyst was 44.8 (18-71), 68 of whom were men and 103 were women. Bile leakage was present in 50 patients (50 (29.23%)). There were 24 (48%) men and 26 (52%) women with bile leakage. The cyst diameter was 74.2 (36-170) mm and the number of cysts was 1.2 (1-2). The cysts were located in the right lobe of the liver in 116 (79%) patients, in the left lobe in 30 (15%) patients, and in both lobes in 25 (6%) patients. Cystobiliary fistula developed more frequently, especially in cysts located in the right lobe(36 (72%)). Cystobiliary fistula was most common in CE3 (Gharbi type 2) type (30 (60%)). Cystectomy+drainage was performed in 137 (80%) patients in all groups. Cystectomy and drainage were the most common surgical procedures. The cyst diameter was 10 cm in the group with cystobiliary fistula and was significant compared to the group without fistula (p&amp;lt;0.001). Aminotransferase (AST and ALT) levels were high in patients with cystobiliary fistula (p=0.012, p=0.054). However, there was no significant difference between the two groups in alkaline phosphatase, total bilirubin, and gamma glutamyl transferase (p=0.231, p=0.097, p=0.544). Conclusion: Liver hydatid cyst is endemic in our country as well as in many other countries in the world. Complicated hepatic hydatid cysts require timely and appropriate treatment because of their life-threatening complications. Cytobiliary fistula is the most common complication. In the surgical treatment of hydatid cyst disease, the earlier the diagnosis of occult cystobiliary fistulas is made (especially in the preoperative or peroperative period), the easier the treatment is, and the risk of bile leakage and consequently the morbidity and mortality decreases. Our results and experience showed that treatment and complications are related to the location and size of the cyst, occult/large cystobiliary fistula, detectability of occult fistulas, experienced center and surgeon.

A 10-year experience of hydatid cysts of lung in association with other extrathoracic system involvement in a tertiary care hospital in Kolkata, India

Background: The metacystode of tapeworm Echinococcus causes hydatid disease. Infection in man is mainly caused by Echinococcus granulosus. Surgical intervention to treat complicated hydatid cyst (HC) is different from uncomplicated HC. Aims and Objectives: The present study was performed with an aim to review 82 cases of pulmonary HCs and associated HCs in other locations. We analyze and evaluate our experience in the surgical treatment and complication. Materials and Methods: In a 10-year period, from August 1, 2005, to July 31, 2015; 82 patients were operated on in our hospital for HCs in pulmonary as well as other associated extrapulmonary locations. The diagnosis was established on the basis of clinical features and imaging studies supplemented by serological test. Surgical approach consisted of a posterolateral thoracotomy in all cases of thoracic HCs. For cysts in extrathoracic locations, either laparotomy or local excisions were performed. Results: Radical resections [lobectomy] were done in four cases, and conservative operations in the remaining. Post-operative complications occurred in 12 cases (14.63 %). We had two recurrences, three cases of prolonged air leak with bronchopleural fistula, two had atelectasis, and five wound infections. At 6 months follow-up, 97.56% of our patients were free of any recurrence. Conclusion: HCs of the lung are best treated with surgery. Even when associated with HCs in other locations in the body, surgery is considered the treatment of choice. When supplemented with long-term perioperative Albendazole therapy, the chance of recurrence is practically negligible.

Pulmonary hydatid cyst mimicking lung tumor in a heavy smoker patient- Uniportal VATS management.

Introduction and importanceHuman infection with E. granulosus leads to the development of one or more hydatid cysts located most often in the liver and lungs. However, radiologically and clinically, analysis of atypical or complicated pulmonary hydatid cysts may resemble other types of malignancies.Case presentationHere, we present a 65-year-old man presented with chest pain, loss of appetite, and weight loss for 6 months' duration. The patient was surgically treated for a pulmonary hydatid cyst that mimicked a lung tumor clinically and radiologically. The patient underwent surgery using a uniportal video-assisted thoracoscopic surgery (UVATS) approach. The patient was put on an anti-helminthic drug (Albendazole table 400 mg twice daily for 21 days and 14 days off). He will continue for 3 cycles on this schedule.DiscussionThe diagnosis of pulmonary hydatid cyst depends mainly on the imaging procedures supported by appropriate serology and often histopathology. The treatment of choice for the pulmonary hydatid cyst is surgical resection. The uniportal video-assisted thoracoscopic surgery (UVATS) method has been proven to be safe and effective around globally. This includes a shorter surgery time, less pain, less chest tube drainage, and less need for painkillers after the surgery.ConclusionIn this report, we present a case of a radiologically and clinically pulmonary hydatid cyst mimicking a lung tumor. In the differential diagnosis of a lung tumor, a pulmonary hydatid cyst should be considered particularly in endemic regions.

Beautiful aspect of hydatid cyst

Hydatid Disease (HD) is a mild endemic disease caused by ecchinococus granulosus. It can affect any system of the body, with hepatic predilection [1,2]. Most often asymptomatic, the literature describes 5 evolutionary stages ranging from simple cysts, with it poses a problem of differential diagnosis in its simple form to complicated forms that may or may not be calcified. It is made up of three sofas; the pericyst, ectocyst, and endocyst. The CT scan plays an important role in imaging complicated hydatid cysts. The most common are rupture and superinfection. Occurring in 50 to 90% of cases, the rupture can be communicative or contained. When contained, the endocyst detaches from the pericyst appearing as a curvilinear structure or floating membranes which may subsequently calcify. This aspect is found on ultrasound, or on a CT scan [1,3]. The case on this hepatic ultrasound (Figure 1A) generated a grossly oval lesion, containing calcified serpiginous structures (floating membranes), generating shadow cones which mask the posterior reinforcement of this non-vascularized fluid mass on color Doppler (yellow star).

Capitonnage surgery is effective in all types of pulmonary hydatid cysts

Background: Hydatid cyst still has worldwide distribution with many cases discovered yearly in endemic areas. It has a predilection to involve the liver and the lung. Capitonnage has been practiced long time to avoid postoperative complications mainly air leak in addition to empyema formation. It may be still controversy concerning the efficiency of capitonnage especially for complicated hydatid cyst which led us to evaluate. Aim of the study: To assess the efficacy of capitonnage surgery in minimizing the postoperative complications and hospital stay in complicated and non complicated pulmonary hydatid cysts. Patients and Methods: A prospective study has been done at the department of thoracic surgery in Al-Jumhory teaching hospital at right side of Mosul, Department of pediatric surgery in Al-Khansaa teaching hospital and in Al-Rabee private hospital at left side of Mosul / Iraq between February 2017 and December 2019. Totally 118 patients with hydatid cyst of lung, including all ages and on different types of complicated and non-complicated cysts were included for this study. Co-morbid diseases like acute myocardial ischemia and uncontrolled diabetes mellitus were excluded from our study. Patients were evaluated in responce to the gender, age, clinical presentation, cyst condition (size, site and where ruptured or not) and postoperative hospital stay. Enucleation of the HC and capitonnage were carried out for all patients. The patient followed for three months at monthly interval, then each year with the mean follow up of 22 months. Results: One hundred eighteen patients with median age of 32 years were operated using capitonnage method. In this study 49 (41.5%) of the patients found to have intact cyst and the remaining 69 (58.5%) had ruptured cyst. We recorded the early postoperative complications which include air leak in 10 cases, Atelectasis 8, pneumothorax 3, wound infection 3 and Hemoptysis in 2 cases. Conclusion: Capitonnage can decrease the incidence of air leak and shorten hospital stay in complicated and non-complicated lung hydatid cysts.