Of 156 patients referred in 1977-1987 for pulmonary hydatid cyst, nine were found to have simultaneous affection of the right lung and the liver. The diagnosis of concomitant liver cyst was made from radiographic dumbbell elevation of the diaphragm (3 cases), by preoperative ultrasound scan and computed tomography in (5 cases), and by intraoperative palpation through the diaphragm (1 case). The hepatic cysts were removed via the thoracotomy performed for removal of the lung cyst in seven patients and via thoracolaparotomy in two. The postoperative course was satisfactory and no recurrence of cyst has been observed, although mebendazole was not given. In cases of hydatidosis of the right lung, preoperative search should be made for subdiaphragmatic concomitant liver cyst which can be removed through the same thoracotomy.

No abstract

Penetrating chest injuries are a challenge to the thoracic or trauma surgeon. Penetrating thoracic trauma, especially that due to high-velocity gunshot wounds, is increasing at an alarming rate in our region. We report our experience with penetrating chest injuries mainly due to high-velocity gunshot wounds. During a period of 6 years we retrospectively reviewed the hospital records of 755 patients admitted to the Department of Thoracic and Cardiovascular Surgery, Dicle University School of Medicine, with the diagnosis of penetrating thoracic trauma. The mean age was 27.48 years, and 89-8% were male. The causes of penetrating injury were stab wounds in 45.3% and gunshot wounds in 54.7%. About 30% of the wounds were due to high-velocity gunshots; and among the gunshot wounds 56.2% were due to high-velocity shots. The most common thoracic injury was hemothorax (n = 190) followed by hemopneumothorax (n = 184). Isolated thoracic injuries were found in 53% of the patients. Nonoperative management was sufficient in 92% of the patients. Thoracotomy was performed in 8.1%. The mean duration of hospitalization was 11.2 days. The mean injury severity score (ISS) was 20.17 +/- 13.87. The morbidity was 23.3% and the mortality 5.6%. Fifty percent of all deaths were due to adult respiratory distress syndrome. Altogether 17% of patients with an ISS > 25 died, whereas only 0.9% of those with a score < 16 died. The mortality due to firearms was 8.95%. We concluded that in civilian practice chest tube thoracostomy remains by far the most common method of treating penetrating injury to the chest. The easy availability of high-velocity guns will continue to increase the number of civilians injured by these weapons.

A series of 460 surgically treated cases of hydatid cyst of the lung is presented. Radiologic preoperative diagnosis was made in 90% of the patients. Cystotomy with subsequent capitonnage was performed in 395 cases, wedge resection in 27, lobectomy in 15 and segmental resection in 23 cases. After careful hemostasis, two drains were placed in the thorax and the thoracic cavity was closed. There were three postoperative deaths (0.6%) and two recurrences of cyst (0.4%) during follow-up investigation for periods up to 10 years.

No abstract