Thoracic Hydatid Cysts Research Articles

Thoracic hydatid cyst: A rare case CT and MRI finding

Hydatid cyst is a worldwide zoonosis. The lungs and liver are the most common sites involved. Extrapulmonary intrathoracic hydatid cysts may include the pleural cavity, fissures, mediastinum, heart, vascular structures, chest wall, and diaphragm. Radiological imaging plays a pivotal role not only in the diagnosis of hydatid cysts but also in the visualization of the extent of involvement and complications. We report a case of a 47-year-old female with a history of chronic pyothorax tuberculosis, treated with antitubercular therapy and a left pneumonectomy in 1998. She complained of chest pain with mild shortness of breath and loss of appetite. CT and MRI showed a voluminous solid cystic process within the left pneumonectomy cavity with extrathoracic and intra-abdominal extension.

Surgical outcome and prognostic factors for 39 recurrent spinal hydatid cysts.

Cystic bone echinococcosis accounts for 0.5-4% of all reported cases, and 45% occur in the spine. Our aim was to review the clinical and radiological features, surgery, and outcomes for 39 patients with recurrent spinal hydatidosis. Thirty-nine reports of patients with recurrent spinal hydatidosis (2011-2020) were followed for an average of 9.28 ± 5.60 months. Lesions occurred in descending order in the; lumbar (48.7%), thoracic (43.6%), and cervical spine (7.7%). Total cyst resection was achieved in 28 of 39 patients (71.8%). Intraoperative cyst rupture occurred in 13 patients (33.3%). The postoperative American Spinal Injury Association (ASIA) score was "good" in 82% of patients. Those with "poor" postoperative ASIA scores had a 41% incidence of recurrent thoracic hydatid cysts; further, they demonstrated significantly higher recurrence rates if cysts had ruptured intraoperatively (P = 0.001). In addition, laminectomy, subtotal original cyst resection (P < 0.007), and a thoracic location were all significantly associated with higher recurrence rates (P < 0.04). The majority of patients demonstrated improvement following surgery for cervical hydatid cysts. Notably, those with poor outcomes typically experienced intraoperative ruptures of their thoracic hydatid cysts, contributing to high cyst recurrence rates.

Intra thoracic extra pulmonary hydatidosis: prognosis and outcomes of 8 operated patients

Hydatid cyst disease is a parasitic disease known from the times of hippocrates, and is still endemic in our country Morocco among others, affecting mainly the liver and lungs, while intra thoracic extra pulmonary location remains a rare entity of the disease. In our department of thoracic surgery, Mohamed VI University Hospital, Oujda, Morocco, we operated 92 patients for thoracic hydatid cyst in the period between January 2016 and December 2021, 8 patients of this group had exclusive extra pulmonary location of the hydatid cyst, epidemiological and clinical data were recorded for the 8 patients (5 men, 3 women). The mean age was 40.3 years, all patients presented mainly with chest pain, dyspnea and cough. The locations of the hydatid cysts were chest wall, pericardium, pleural space and diaphragm. The hydatid cysts were removed via extirpation technique through thoracotomy in all patients. The average duration of hospitalization was 7 days. Postoperative complications consisted of atelectasis in one patient, parietal hematoma in another, and surinfection with pleuro-cutaneous fistula and chronic neurological chest pain in one patient. No deaths were noted in our series.

COMPUTED TOMOGRAPHY IMAGING PRESENTATION IN THORACIC HYDATID CYSTS

Hydatid cysts are widespread zoonosis that originate from the larval embodiment of the Echinococcusand can be frequently found in the lung and liver parenchyma, in addition, they emerge in various atypical locationsin the thoracic cavity such as the mediastinum, its vascular compounds and the heart, the interlobar fissures, thepleural and pericardial space, as well as the structures of the chest wall and the diaphragm. Computed tomographyas one of the most utilized instruments of radiology imaging has a crucial role in the diagnosis of hydatid cysts,depiction of their exact size and location, as well as estimation of impending complications.The aim of this pictorial review is to offer full scale understanding of the recurrent imaging findings in thoracichydatid disease as well as to display some rare, extra parenchymal involvement and a summary of the complicationsand differential diagnosis.We did an in depth analysis of 55 chest CT scans of patients with thoracic hydatid cysts from North Macedonia andall patients underwent a contrast enhanced chest CT according to appropriate diagnostic protocol on a 16- sliceSomatom GO computed tomograph (Siemens Healthineers, USA).Hydatid cysts in all 55 patients were divided by location and appearance in two by two categories, uncomplicatedparenchymal and extra parenchymal, and complicated or ruptured parenchymal and extra parenchymal cysts.Uncomplicated parenchymal hydatid cysts were presented by well circumscribed, low attenuating, homogenouslesions with smooth walls of varying thickness, whereas complicated or ruptured hydatid cysts could be categorizedin two forms, contained or complete rupture. The most frequent imaging findings were the air crescent sign,waterlily sign and dry cyst sign. Uncommon extra parenchymal hydatid cysts’ locations were the mediastinum,pericardium and the diaphragm.Computed tomography plays an important diagnostic role in common thoracic hydatid cysts and aids in theevaluation of rare and complicated cases.

Unusual imaging characteristics of thoracic hydatid disease.

Cystic echinococcosis (hydatid disease) is a zoonotic parasitic disease, caused by ingestion of Echinococcus granulosus eggs, that can result in cyst formation anywhere on the body. Hydatid disease is frequently seen in regions where there is human-animal contact and poor socioeconomic development. The prevalence of the disease ranges from 0 to 79 cases/100,000 population. Hydatid cysts are typically found in the liver and lungs, being less common in other parts of the body. Computed tomography or magnetic resonance imaging is often used in order to clarify the sites affected by a hydatid cyst, such as the cranial and thoracic regions, which also facilitates the surgical evaluation and minimizes complications. Although rare, hydatid cysts in atypical locations can provoke unusual complications, with unpredictable findings and symptoms. This essay discusses the radiological aspects of rare thoracic hydatid cysts.

Thoracic hydatid cysts: an analysis of surgical management in a tertiary care centre in India.

Though hydatidosis is a ubiquitous zoonosis endemic to India, there is a dearth of literature regarding the management of thoracic hydatid disease (THD) in India. There are no surgical guidelines available. The aim of this study is to analyse the details of THD operated upon in a tertiary care hospital in India and propose a protocol for its management. The case files of all adult patients operated upon for THD in our institution between 2009 and 2019 were retrieved and a retrospective study done. A total of 186 patients, 103 (55.4%) males and 83 (44.6%) females, with a mean age of 34.2years were studied. The commonest symptom was cough as in 83 (44.6%) patients. Complications were seen in 22 (11.8%) patients. Computerized tomogram (CT) was confirmatory in most patients. Isolated pulmonary disease was seen in 135 (72.6%) patients with 153 (82.3%) uni-lobar involvement. Right lower lobe was most frequently involved as in 56 (30.1%). Extra-pulmonary, intra-thoracic involvement was seen in 6 (3.2%) and synchronous extra-thoracic disease in 45 (24.2%) patients. All patients were initiated on anthelmintics. Postero-lateral thoracotomy was the commonest surgical approach. Twenty (10.7%) patients required lung resections. The mean hospital stay was 5.9days. Air leak, seen in 10 (5.4%) patients, was the commonest post-operative complication. There was single in-hospital mortality. Age, diabetes mellitus, secondary bacterial infection of the cyst and cyst characteristics were found to significantly affect the surgical outcomes. Surgery, the treatment of choice for THD, can be done with negligible morbidity and mortality and should be expedited to prevent complications. Risk factors should be identified pre-operatively for better decision-making. Adequate concurrent medical therapy may prevent recurrences. Prolonged follow-up is mandatory to detect late recurrences.

Wandering parasite: endoscopic management of hydatid cysts of abdomen encroaching thorax.

Minimal access surgery has opened avenues of hybrid approach for abdominal hydatid cysts extending into thorax. This approach of combined laparoscopy and thoracoscopy should be evaluated for its feasibility and efficacy. Present prospective study was designed to highlight the feasibility and utility of endoscopic approach in the management of complex hydatid cyst of the liver and spleen extending into the thorax. Patients undergoing combined Laparoscopy and thoracoscopy for abdominal hydatid cysts extending into thorax over a period of 4years were included in the study. Their clinical features, investigations, imaging, treatment and duration of hospital stay were studied. Clinical outcomes were assessed with respect to morbidity and mortality using Calvien Dindo scale. A total of 15 patients were studied. All patients had thoracic hydatid cysts with liver involvement in 12, splenic involvement in 2, and both liver and spleen in 1 patient. The most common symptom was pain in the abdomen in 11 patients (73.3%) followed by lump in the abdomen in 2 patients (13.33%), and dyspnoea in 2 patients (13.33%). Computed Tomography was diagnostic in all patients. Most common type was Gomez type 1 (7 patients) followed by Gomez type II (3 Patient) and Gomez type III (2 patient). The mean operative time was 120min. Mean hospital stay was 10days. Pleural effusion being the commonest postoperative sequelae. This endoscopic approach for liver and splenic hydatid cyst extending into thorax is feasible and averts morbidities of thoracotomy.

Imaging of Thoracic Hydatid Cysts, Point of view of the Radiologist

Imaging of Thoracic Hydatid Cysts, Point of view of the Radiologist

Anterior Approach for Thoracolumbar Fracture Dislocations: Surgical Management in Poor Resource Region, Record of 7 years Follow-up

Introduction: Thoracolumbar fracture dislocation is a trauma of high energy which generally is treated with longsegment stabilization. Anterior spine exposure may be used alone or in combination with a posterior midline approach in a staged or sequential fashion. In this study, we report the 7-years’ experience of the anterior approach to the thoracolumbar spine fracture dislocations at a single institution. Patients and methods: Over a 7-year period (2007–2014), 15 patients (9 males and 7 females) with a mean age of 41.1 years ranging between 25 and 61 years, were operated on using an anterior approach at our institution. All patients were submitted to standard anterior spine surgery, thoracotomy (in 9 patients), thoracophrenolumbotomy (in 3 patients) and lumbotomy (in 2 patients), one patient required left thoracotomy alone. In all cases, we used heavy duty plate fixation and autologous bone (rib or vertebral bone) inside the cylinder. The criteria for surgical intervention were: partial or progressive neurologic deficit, kyphotic angulation =25o at one segment, progressive kyphosis, lesion with a loss of 50% of vertebral height with angulation and a residual canal diameter 50% of normal. All patients had a failure of the anterior and middle columns as viewed on a CT scan or MRI if available. Results: The average duration of follow-up was 24 months. One patient died during the follow-up period. Concerning ethiology, there were two types of vertebral body lesions, which were traumatic and infectious. There were also 12 patients with traumatic lesions. The mean age was 41.1 years (range 25-61). There were 10 males and 5 female patients. Six patients had a burst fracture (type A3), with compression failure of the anterior and middle columns of the spine (level T12 in 3, level T11 in 1, level L1 in 2,). All patients with traumatic lesions underwent singlestage anterior fixation by heavy duty conventional plate and screw and the gap filled with autograft (rib and morselized vertebral bone). Three patients were operated because of the thoracic and lumbar tuberculous spondylitis and Hydatid cyst (one patient T9, one at T10, one T5). Discussion: Initial reports of the anterior thororacotomic approach to the thoracic spine were related to Pott’s disease, spine surgery innovations and aging with a more active population resulting in a progressive increase in spine instrumentation. The main indication for anterior decompression is an incomplete neurological injury with radiographically demonstrated neural compression by bone or disk fragments. The anterior surgical treatment allows direct decompression of the neural elements and correction of the deformity. Conclusion: The anterior approaches provide excellent exposure of the relevant bony anatomy and can be used to secure anterior column support with bony fusion. Anterior spinal fusion surgery is a safe procedure and can be used with confidence when the nature of a patient’s spinal disorder dictates its use.

Endoscopic closure of tracheoesophageal fistulas with the over-the-scope clip system.

Management of Tracheoesophageal Fistulas (TEFs) is associated with high morbidity and mortality and remains an interdisciplinary challenge. We describe the first two cases of successful endoscopic closure of TEFs due to tracheostomy tube and thoracic hydatid cysts surgery, using the Over-The-Scope Clip (OTSC) system. The OTSC system is composed of an application cap, which is mounted onto the distal tip of the endoscope and a connected releasing mechanism, installed on the handle of the scope. The rotation of the handle allows the release of the clip by a two tube sliding mechanism. Atraumatic version of OTSCs with medium sized caps, twin graspers and anchor were used in these cases. Both fistulae were successfully sealed with one clip. No complication was observed that could be ascribed to the clip itself or to the technique. One patient died because of pneumonia and septicemia after 1 week, but the symptoms of other patient were immediately improved. A thoracic radiography taken after 1 month showed that the clip is in place. Although prospective comparative clinical studies are needed to work out the drawbacks of the new OTSC device, it might be considered as a valid alternative to operation in TEFs.

Video-Assisted Thoracoscopic Surgery to Treat Hydatid Disease of the Thorax in Adults: Is It Feasible?

Optimal treatment of intrathoracic hydatid diseases in adults involves complete removal of the cyst with parenchyma-preserving surgery. In current practice, thoracotomy remains the standard surgical approach for pulmonary hydatid cysts, so surgical experience is limited, particularly with regard to video-assisted thoracoscopic surgery (VATS). Between June 2007 and May 2011, a selected series of 12 adult patients presenting with intrathoracic hydatid cysts underwent VATS. The cysts were completely removed using a three-trocar technique. Complete removal of the cysts was successful in all patients. All cysts were diagnosed by computerized tomography, and 6 (50%) patients had a history of hydatid disease in the liver or lung. No serious postoperative complications were observed. Patients with thoracoscopic excision were discharged after a median of 2.9 days (range, 2-6 days). No recurrences or complications were observed during a mean follow-up of 29 months. Considering the conversion and complication rates in our series, VATS should be the primary therapeutic choice for adults with thoracic hydatid cysts. Open surgical interventions in patients with large and uncomplicated cysts appear optional.

Costal hydatidosis: management and outcome of five cases

The objective of the study was to report our experience in the management of hydatid cyst of the rib. Between December 2001 and December 2009, five patients underwent surgery for costal echinococcosis, among 234 cases of thoracic hydatid cyst managed in our department. They were three males and two females, aged 19-42 years (mean = 32.2 years). Imaging investigations consisted of chest X-ray and computed tomography. All the patients underwent thoracotomy along the arch of the infected rib. Albendazole was administered postoperatively in all cases. The echinococcosis of the rib was primary in 3 cases, and secondary to thoracic localization in 2 cases. It was located on the right side in four patients, on the left one in one patient. The posterior arch was the site of infection in 3 cases, and the anterior arch in 2 cases. The cyst was intact in 4 cases, and the invasion of adjacent structures was found in one case. There were no concomitant hydatid lesions. The resection of the infected rib was total in 2 cases and partial in 3 cases. There was no postoperative mortality or complications. The follow-up ranged from 28 months to 8 years did not show any recurrence. Echinococcosis of the rib is very rare. To avoid complications and to allow the eradication of the disease, the combination of surgery and antihelmentic drugs remains the best therapeutic choice.

Thoracic Hydatid Disease; A Review of 763 Cases

Thoracic hydatid disease remains a significant health problem in endemic areas. The aim of this study was to retrospectively evaluate 763 patients diagnosed with thoracic hydatid cysts and treated surgically at Ibn-Alnafis Teaching Hospital between January 1986 and January 2006. All patients underwent surgery. The mean age was 26 years. Intact cysts were enucleated in 468 patients after injection with a scolicidal agent and the remaining cavity was left open after securing localised air leaks. Pulmonary resections were performed in 198 patients. Most cysts were removed without lung resection. Resection was reserved for large cysts, severe suppuration and complicated cases with haemoptysis or bronchiectasis. However, lung preservation was always attempted initially. In patients with intact lung cysts, 37% were asymptomatic with incidental diagnosis on routine chest X-ray. Mortality was 1% and morbidity was 12.6%. Lung preservation without obliteration of pericystic cavity provides good result in patients with uncomplicated hydatid cysts. Radical resection should be reserved for complicated cases. Medical treatment is indicated postoperatively especially for recurrent or multiple hydatid cysts.

Unusually located thoracic hydatid cysts

Unusually located thoracic hydatid cysts

Unusually located thoracic hydatid cysts.

Human hydatid disease caused by the larval form of Echinococcus granulosus has a worldwide distribution and is endemic in many countries. The disease, known since the time of Hippocrates, is primarily an illness of residents in rural areas who frequently come into contact with sheep, cows and carnivores.1-4 The estimated surgical case rate of cystic echinococcus is 0.87-6.6 per 100 000 in Turkey.2 The prevalence of Echinococcus granulosus infestation in dogs in Turkey is between 0.32% and 40% and the reported prevalence of cystic echinococcus in domestic animals has ranged from 11.3 to 50.7% and varies widely by geography.5,6 Echinococcal cysts may develop in almost any part of the body. The liver and the lungs are the most commonly affected areas in adults. Within the thorax most of the cysts settle in the lung parenchyma. In this situation surgical treatment is usually easy and quick. Sometimes the cyst grows as an extrapulmonary lesion or passes over the lung parenchyma to other structures. Location of the disease outside the lung parenchyma in the thorax is rare and surgical procedures can be considered that may differ from those used for pulmonary cysts.7 The aim of this study was to review surgical techniques and possible perioperative complications. We present our experience, documenting the clinical features and the treatment employed for unusually located thoracic hydatid cysts.

Unusual Radiologic Manifestations of the Echinococcus Infection in the Thorax

Unusual location and presentation of hydatid cyst disease in the thorax requires careful consideration with respect to clinical approach and therapy. In this pictorial essay, we present imaging findings and describe treatment of thoracic hydatid cysts in patients with lung, mediastinal, chest wall, cardiac, endobronchial, pulmonary artery, and diaphragmatic involvement. A review of the literature is also included.

Fifty thoracic hydatid cysts.

Journal Article Fifty thoracic hydatid cysts Get access John Borrie John Borrie Department of Surgery, University of Otago, and the Otago Hospital Board's Base Regional Thoracic Surgical Unit, Dunedin, New Zealand Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 50, Issue 221, November 1962, Pages 268–287, https://doi.org/10.1002/bjs.18005022107 Published: 06 December 2005

Unusually located hydatid cysts: Intrathoracic but extrapulmonary

Hydatid cyst disease is still a problem in Turkey, as well as in many other places in the world. Extrapulmonary location of the disease in the thorax is very rare, and surgical procedures can be considered that differ from those used for pulmonary hydatid cysts. We reviewed retrospectively our experience in the surgical treatment of 22 patients with intrathoracic, extrapulmonary hydatid cysts. In our department, 297 patients with thoracic hydatid cysts were managed surgically in the last 14 years, in 22 (7.4%) of whom the cysts were localized extrapulmonarily in the thorax. The locations of these hydatid cysts were a fissure, the pleural cavity, chest wall, mediastinum, myocardium, and diaphragm. Total resection was chosen as the surgical procedure in all patients except 4 (18.2%), 1 of whom had cystectomy and capitonnage for cardiac hydatid cyst and 3 of whom had cystectomy and local curettage for cysts located in the chest wall. Empyema developed postoperatively in 1 case (4.5%) with a cyst in the fissure. The follow-up period was 1 year, and there were no deaths. Hydatid cyst may be found in many different sites, including extrapulmonarily in the thorax, and bearing this in mind will facilitate planning of the operation.

Radiographic, CT and MRI spectrum of hydatid disease of the chest: a pictorial essay

Thirty patients with thoracic hydatidosis (Echinococcus granulosus) were studied. The hydatid cysts were located in the lung parenchyma (70%), mediastinum (6.7%), inside the heart (10%), the pleurae (10%) and the chest wall (3.3%). complications of thoracic hydatid cysts, such as rupture, infection, pleural involvement, spread and calcifications are presented. Computed tomography (CT) without and/or with contrast enhancement was performed in all patients (30). Findings from conventional chest radiographs were compared with CT and confirmed by pathology (30). In 10 cases (33.3%), magnetic resonance imaging was also performed. The diagnostic spectrum of hydatid cysts, including variations and developmental stages, is presented in this pictorial essay.

Thoracic Hydatid Cysts: A Report of 842 Cases Treated Over a Thirty-Year Period

From 1957 to 1985, 842 patients were diagnosed as having thoracic hydatid cysts; 810 cysts were intrathoracic, 29 occurred on the "liver roof," 2 were cardiac, and 1 was on the chest wall. A total of 1,010 surgical procedures were performed in 807 patients (35 refused operation). There was a total operative mortality of 0.6% (5 deaths). Procedures became more conservative as experience was gained, and 79% of the procedures were endocystectomies. Intact endocystectomy (Barrett's technique) without preliminary aspiration was the approach of choice. Careful protection of the operating field, suturing of all the bronchial openings, and capitonnage were the keys to successful treatment. One hundred six patients with intact endocystectomies done before July, 1975, were followed for 3 to 20 years. Ruptures occurred during cyst manipulation in 35 patients (33%). Recurrence after operation was seen in 2 patients (1.9%). There were no deaths among the patients undergoing intact endocystectomy. In comparison, we followed 136 patients who underwent aspiration endocystectomy and the recurrence rate was 3.7% (5 patients).