Management of giant hydatid cysts: a tertiary centre experience

Abstract

Background Hydatid cyst (HC), the most parasitic disease of the lung, is still an important health problem in Tunisia. In this study, we reviewed our experience in a surgical management of 33 patients with giant pulmonary hydatid cyst (GPHC) (diameter ≥ 10 cm). Main body Between 1998 and 2019, a total of 33 patients with GPHC were operated in the Thoracic Surgery Department in Abderrahmane Mami Hospital. Seventeen were males (51.51) and 16 were females (48.48%). The median age was 33.9 years (range 7–83 years). The diameters of the cyst ranged between 10 and 20 cm (mean 13.15 cm). The most common symptoms were chest pain (63.63%) and cough (33.33%). Imaging showed a single GPHC in all cases. GPHC was intact in 75.75% cases and complicated in 24.25% cases. Posterolateral thoracotomy was performed in 27 cases (81.81%). For the residual cavity, parenchyma-saving procedures were performed in 54.54% and anatomical resection was performed in 45.46%. Morbidity was low, and no mortality was seen. Conclusion GPHC are considered more difficult to treat surgically than small cysts; parenchyma preserving should and could be the surgical method of choice with a good prognosis. The decision of anatomical pulmonary resection is taken in per-operative when conservative surgery is not possible.

A 16-year-old adolescent with a history of minor abdominal trauma diagnosed with a giant isolated primary splenic hydatid cyst: a case report

“…Splenectomy stands as the conventional and optimal treatment choice due to its associated low morbidity and mortality rates. Total splenectomy is recommended in cases where the spleen is nearly entirely occupied by the HC, when dealing with giant cysts (HCs with a diameter of 10 cm or larger are referred to as “giant” cysts 13 ) at an elevated risk of rupture or compression of vital structures, or when multiple cysts are present, particularly in more central or hilar locations. While total splenectomy may entail a higher risk of morbidity and mortality, it is nonetheless recommended in poor and underdeveloped countries.…”

Parenchyma Preserving Surgery in Giant Hydatid Cyst of Lung: A Case Report

“…Echinococus Granulosus with a global existence. 4 The lungs are the second most common site for hydatid cysts after the liver. 5 Patients with hydatid cysts are usually asymptomatic for longer as the cyst grows slowly.…”

“…7 Diagnosis is common and easy in endemic areas suspected with the presence of a cystic lesion in the lung with a history of exposure to sheep and dogs. 4,8 Conventional X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) of the lungs are the various modalities useful in the diagnosis of thoracic hydatid cysts. Though the role of ultrasound in thoracic hydatid cyst is limited, unless the cyst is close to the chest wall, 9 but in our case, it was helpful as the thick wall with hydatid sand was seen which drew us close to the diagnosis.…”