Hydatid cysts of the liver diagnosis, complications and. Cystic echinococcosis ce is a zoonotic parasitic disease caused by the larval stages of the cestode echinococcus granulosus. Lung hydatid cyst an overview sciencedirect topics. Between 1994 and 2001, 71 patients with pulmonary hydatid cysts were treated surgically.
Here we presented a patient who presented with concurrent involvement of both lungs and liver. The aim of this retrospective study was to compare the cost and effect of a onestage operation with those of two or threestage operations in the treatment of lung hydatid cysts with multiple. Of 1055 patients treated surgically for pulmonary hydatid disease, most 950 had isolated lung cysts, the other 105 having both liver and lung cysts. Surgical operation, which should be performed soon after diagnosis to prevent complications such as cyst rupture or infection, is the principal method of treatment. The clinical presentation and the preoperative and postoperative complications associated with pulmonary hydatid cysts depend on whether the cyst is intact or ruptured. In one, the pain was localized to the area overlying the cyst and in this case the cyst was. The ideal surgical method for treating this disease is still unknown.
The two main types of the disease are cystic echinococcosis and alveolar echinococcosis. Growth rate of the parasite changes with the hosts sensitization degree and tissue influence. Echinococcus granulosus, ce, pair, pulmonary echinococcus. Hydatid cyst disease of the lung as an unusual cause of. The medical records for 58 patients of pulmonary hydatidosis were retrospectively investigated. Multiple pulmonary hydatid cysts 777 embolic hydatid infection in the blood vessels, spread through the lymphatics, or possibly from an endobronchial spread from one lung to the other. The two main types of hydatid disease are caused by e. May 07, 2019 hydatid disease is a parasitic infestation by a tapeworm of the genus echinococcus.
Spontaneous expectoration of an isolated pulmonary hydatid. As the antibodies to echinococcus were positive in the serum, she was diagnosed with pulmonary hydatid cyst and referred for surgical management. A 22yearold male came to our emergency department in shock with symptoms of. Cystic echinococcosis hydatid disease news medical. Patients admitted with a pulmonary hydatid cyst from 1981 to 2008 were enrolled in this study. In this study, we report our 10 years of experience with giant hydatid cysts of the lung. May 01, 2012 due to dog tapeworm in larval or cystic stage. From the embryo released from an egg develops a hydatid cyst, which grows to about 510 cm within the first year and is able to survive within organs for years. The clinical finding, diagnosis and outcome of patients with.
The most common sites of lodgment of echinococcus granulosus are the liver and the lung. Pulmonary hydatid infection is a common manifestation of hydatid disease. Ruptured pulmonary hydatid cyst with anaphylactic shock and. Case report successful management of a huge pulmonary hydatid cyst with lungpreserving surgery armin amirian,1 bizhan ziaian,1 amirhossein erfani,1,2 reza shahriarirad,1,2 and keivan ranjbar1,2 1thoracic and vascular surgery research center, shiraz university of medical sciences, shiraz, iran 2student research committee, shiraz university of medical sciences. Intact hydatid cysts were found in 67 patients and infected or rup. Hydatid infestation of the lung can be primary or secondary. Pulmonary hydatid disease affects the right lung in.
The resulting large cysts in the lung are a special clinical entity called giant hydatid cysts. The diagnosis of complicated pulmonary hydatid cysts may not be easy because hydatid cyst disease mimics tuberculosis, lung cancer, empyema, or abscess. However, it is mostly expected to result in suppuration that leads to the formation of an abscess in the rupture of lung hydatid cyst. They exhibited different rates of growth in the same patient with a maximum growth of 7 cm. Salmones mg, gil r, rabanal jm 1997 anaphylactic shock during pulmonary hydatid surgery. Jun 25, 2016 hydatid disease of the lung nickolaos n. When the egg lodges in mans stomach, the course not. Radiological characteristics of pulmonary hydatid cysts.
Solak 3, 7, 9 studied and showed higher incidence in male than. Hydatid disease is caused by an infection with the cestode, echinococcus granulosus and is endmic in iran. Hydatid cysts are found more frequently in the lungs of children and adolescents than in. Hydatid disease is a worldwide zoonosis produced by the larval stage of the echinococcus tapeworm. Less common forms include polycystic echinococcosis and unicystic echinococcosis. Oct 15, 2014 pulmonary hydatid cyst is endemic in our country.
In patients with coexisting liver cysts the thoracic transpleural approach allowed the lung and liver cysts to. Complicated hydatid cysts of the lung the annals of thoracic. Complications of albendazole treatment in hydatid disease of lung. Cysts sometimes grow to be so large that by the end of several years or even decades, they can contain several liters of fluid. Hd can occur almost anywhere in the body and demonstrates a variety of imaging features that vary acco. Uncomplicated cysts remain asymptomatic or produce subtle. Parasitic infestation by hydatid cyst when complicated is a common indication for resection in iraq. Pulmonary hydatid cyst, a parasitic disease, is a health care problem in developing countries. Lungs are the second most common site of involvement after liver.
Amritsar, india hydatid disease is not as rare inourpartof the world as suggested by the paucity of published reports. Albendazole is widely used as a primary treatment in hydatid disease of the liver and successful results have been reported. We report a case of 26 year old woman who had ruptured hydatid cyst of the right lung. It is not endemic in the united states, but the change in the immigration patterns and the marked increase in transcontinental transportation over the past 4 decades have caused a rise in the profile of this previously unusual disease throughout north america. One thousand and seventy seven primary operations were performed. Also called hydatid cyst humans become infected by eating food contaminated with tapeworm eggs, becoming intermediate hosts eggs from dog tapeworm echinococcus granulosus or e. Hd can occur almost anywhere in the body and demonstrates a variety of imaging features that vary according to growth stage, associated complications, and affected tissue. Clinical course differs according to cyst hydatid localization at the liver or lung. Disseminated hydatid cyst of liver and lung bmj case reports. Bilateral pulmonary hydatid cyst in an 11 year boy. Hydatid disease hd is a unique parasitic disease that is endemic in many parts of the world. The diagnosis of complicated pulmonary hydatid cysts may not be easy because hydatid cyst disease. There were 41 male and 30 female patients with a mean age of 30.
The tendency of the disease to remain quiescent over long periods and lack of availability of proper diagnostic facilities on a large scale contributed to the lack of knowledge. Hydatid disease is a parasitic infection caused by echinococcus granulosus eg, characterized by cystic lesions in the liver, lungs, and rarely in other parts of the body. Surgical management of pulmonary hydatid cysts ncbi. One patient had multiple cysts with involvement of the lungs, the liver and the left kidney fig. Lung hydatidosis is a parasitic infection caused by larval stage of echinococcus granulosus. Hydatid disease is a parasitic infestation by a tapeworm of the genus echinococcus. Iran is recognized as an endemic area for lung hydatidosis.
Surgical removal of some hydatid cysts may have setious morbid consequences. Hydatid cyst is a parasitic infestation caused by echinococcus granulosus. Uncommon hydatid cyst in lung journal of intensive. Posterolateral thoracotomy and cyst excision were performed in all patients. Xxxviii hydatid cyst of the lung 639 ease as one of the causes producing such symptoms, especially in areas where the disease is endemic. It is concluded that a lung conserving surgical operation is the treatment of choice for most patients with pulmonary hydatid disease. The growth rate of the hydatid cyst depends on the softness of the organ and surrounding tissue elasticity. The patient was probably infected with echinococcus granulosus from stray dogs.
Hydatid disease of the lung caused by echinococcus granulosus is frequently encountered in mediterranean countries. Four patients complained of pain in the chest and it was the presenting symptom in two. The modern treatment of hydatid cyst of the liver varies from surgical intervention to percutaneous drainage or. Intraoperatively communication between cyst and bronchus could be demonstrated. Hydatid cysts of the lung are known to remain silent for a long period without causing any or only minimal symptoms. Patients and methods clinical files of 285 patients who had undergone oper ations for hydatid disease of the lung in the heybeliada. Ct scan chest with contrast showed multiple rounded soft tissue. Hydatid cysts of the liver diagnosis, complications and treatment 107 3. The hydatid cysts of the lungs were commonly solitary, well circumscribed, polycyclic, unruptured, at the lung bases, and at the posterior segments. Ruptured pulmonary hydatid cyst with anaphylactic shock. Diagnosis of pulmonary hydatid cyst by bronchoscopy. Case history an eleven year old male child presented to pediatric emergency with shortness of breath, cough and expectoration. Giant hydatid lung cysts european journal of cardio.
The mediterranean basin is an important endemic area 6,7. Successful management of a huge pulmonary hydatid cyst. The parasite resides in the intestines of dogs, cats as well as in sheep. For a general discussion, and for links to other system specific manifestations, please refer to the article on hydatid disease. Pleural involvement with hydatid disease can develop in one of three situations. Thoracotomy is the best procedure for removing a hydatid cyst, but videoassisted thoracic surgery is suggested for selected patients 9. Discussion 2 this study showed the high incidence of lung hydatid disease in children older than 6 years 75%. Pdf surgical treatment of complicated pulmonary hydatid cyst. Simultaneous lung and liver cysts are observed in less than 10% of the cases. Apr 16, 2018 twelve 40% patients had perforated cysts. To describe and illustrate the common imaging features of various types of thoracic hydatid cysts including pulmonary and extrapulmonary location. Hydatidosis is a parasitic zoonotic disease caused by infection by the metacystode stage infective larvae of the dog tapeworm, echinococcus granulosus, which. However, cases of no symptom development could be as high as ranging between 5 and 45%.
Pulmonary echinococcosis european respiratory society. Background hydatid disease is caused by the larval form of the tape worm cestode echinococcus. Hydatid cyst of lung, sitting intubation, double lumen endotracheal tube dlt. Hydatid cyst is a disease caused by a parasitic tapeworm, echinococcus granulosus, and most commonly involves liver and lung. Hydatid cyst of the lung was most frequent on the left side. Their demographic data, the sites and number of cysts. In patients with coexisting liver cysts the thoracic transpleural approach allowed the lung and liver cysts to be removed at the same session. The period of initial growth of primary hydatidosis is frequently asymptomatic. Hydatidosis of a different location, particularly the liver, may be associated. Roentgen analysis of 50 cases of hydatid disease of the lungs is presented. In faisal habas series, surgery for pulmonary hydatid cyst constituted 2535% of thoracotomies. Diagnosis in nonendemic regions is often delayed due to a failure to consider hydatidosis. Pathology hydatid cyst structure a primary cyst in the liver is composed of three layers. A complicated cyst also is noted at medial lobe of right lung.
Symbas hydatid disease has been known since ancient times. Echinococcosis remains a significant health problem in endemic areas, including the middle. Complete rupture would invariably lead to death, either due to. The disease often starts without symptoms and this may last for years. Hippocrates referred to it and rudolphi40 first used the term hydatid cyst to describe echinococcosis in humans. Hydatid cysts are found more frequently in the lungs of children and. Ruptured pulmonary hydatid cyst can present a diagnostic challenge, and radiograph can be inconclusive.
This results from a nonspecific presentation and a failure to record an accurate geographical history. Eggs are eliminated with feces and they contaminate. Hydatid cyst commonly affects liver followed by lung, but rarely affects both organs simultaneously. Cystic echinococcosus has a world wide geographical distribution. Complications of albendazole treatment in hydatid disease. The chest radiograph and ct features were suggestive of a ruptured hydatid cyst with detached and collapsed endocyst within the exocyst. We report a case of 11 year old male with pulmonary hydatid cyst in both lung parenchyma with hydatid cyst on left side being complicated type. Multiple hepatic cysts with a large splenic cyst are seen. Hydatid cysts of the lung i the american journal of surgery. Small masslike lesion also is detected at lower lobe of left lung. Feb 26, 2019 cystic echinococcosis hydatid disease represents an emerging illness found in humans and livestock that arises as a result of eating infective eggs of the cestode parasite echinococcus. Currently there are no designated guidelines for the management of giant lung hydatid cyst.
Uncommon hydatid cyst in lung introduction echinococcosis also called as hydatidosis is the important zoonotic diseases caused by echinococcus granulosus. Humans become infected by eating food contaminated with tapeworm eggs, becoming intermediate hosts eggs from dog tapeworm echinococcus granulosus or e. Between 1996 and 2009, 58 patients with a total of 74 ruptured lung hydatid cysts were operated. In the liver hydatid cyst, allergic reactions depending on spontaneous cyst rupture are reported but the case of lung hydatid cyst that appears with anaphylaxis is very rare 28 28. Cough, fever, dyspnea, and chest pain were the prominent symptoms in the majority of cases. Most authors advocate conservation of the lung parenchyma, reserving resections for.
Diagnosis and treatment of pulmonary cystic hydatidosis. Echinococcosis is a parasitic disease of tapeworms of the echinococcus type. Hydatidosis, or cystic echinococcosis, is an important zoonotic disease. Pulmonary hydatid disease the annals of thoracic surgery. A hydatid cyst can grow in the human and vegetables. Pulmonary echinococcosis can follow intrathoracic rupture of a cyst of the liver 12, but most patients with pulmonary hydatid disease do not show liver involvement. The symptoms of cases with hydatid lung cyst include. The medical records for 58 patients of pulmonary hydatidosis. All of the cases were symptomatic in our giant hydatid lung cyst group. Interesting ct appearance and demonstrable communication of cyst with bronchus is the reason. Treatment of hydatid liver cyst has to be considered mandatory in symptomatic cysts and recommended in viable cysts because of the risk of severe complications. Patient presented with dyspnoea and generalised weakness with bilateral rounded opacities throughout the lung field of variable sizes. Hydatid cysts result from infection by the echinococcus species, and can result in cyst formation anywhere in the body.
The current treatment of hydatid cyst of the lung is complete excision of the disease process with maximum preservation of the. Lungs and liver are the most frequent sites involved. To describe and illustrate the common imaging features of complicated hydatid cyst in the lung. Anaphylactic reaction is a rare complication of ruptured pulmonary hydatid cyst. In this study, we evaluated outcomes of patients with pulmonary hydatid disease who were treated in our department. Its larval stage cause hydatid cyst most commonly in liver and lung. It is responsible for most of the thoracotomies in our practice. Cystic hydatid disease is a zoonosis caused by infection with the larval cysts of echinococcus granulosus. Pulmonary hydatid infection radiology reference article. The cyst may be symptomless for a considerable time, and may only. The chest radiograph was most valuable in diagnosis.
The current treatment of hydatid disease of the lung is complete excision of the cyst, including the germinative membrane, with the maximum preservation of lung tissue. The surgical treatment performed was pair mostly in cysts more than 6 cm or with complications. The symptoms arise either as a result of pressure of the growing cyst on the surrounding structures or most commonly because of the complications which befall the cyst. Hepatic, splenic and pulmonary hydatid cysts radiology case. Operations on the left lung, the right lung and the liver disclosed perhaps as many as 100 hydatid cysts. The modern treatment of hydatid cyst of the liver varies from surgical intervention to percutaneous drainage or medical therapy. It is only partial rupture of a hydatid cyst that would cause dissemination of the hydatid.