Excision of a Giant Hydatid Cyst of the Lung under Thoracic Epidural Anaesthesia

Abstract

We present a patient with a large pulmonary hydatid cyst compressing underlying lung, with previous pulmonary tuberculosis, who presented in respiratory failure. After institution of thoracic epidural anaesthesia employing 0.25% bupivacaine, 1% lignocaine and fentanyl, the patient was placed in the sitting position and the hydatid cyst excised and drained after a limited rib resection. An air leak persisted until the 16th postoperative day. A marked improvement in symptoms as well as in spirometry and arterial blood gases occurred, and the patient was discharged on the 20th day. Thoracic epidural anaesthesia may be a safer method than general anaesthesia for removal of a hydatid cyst in a patient with severe respiratory compromise.

Our clinical experience and follow-up results in hydatid cyst cases: a review of 393 patients from a single center

“…It is reported that in the lung, the right lobe is more commonly affected. 12 In our study, the majority of the patients (75.2%) had hepatic involvement. Pulmonary involvement was present in 19% of the patients and, particularly, the right lobe was more commonly involved in patients with pulmonary involvement.…”

Clinical and Parasitological Studies on Pulmonary and Hepatic Hydatid Cysts in Hospitalized Children and Adults

“…Khanfar (2004) reported that liver was the obvious first site (55-70%) after entry in the portal circulation through the gut and most cysts tended to be located in the right lobe. Dyer et al (2001) added that the lung (18-35%) was the second most common site of haematogenous spread. It had predilection for the right posterior segment with 60% of cases manifesting in the lower lobes.…”