IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711
Int J Clin Exp Med 2010;4(3):220-226

Original Article
Therapeutic strategies for complications secondary to hydatid cyst rupture

Ufuk Cobanoglu, Fuat Sayır, Abidin Şehitoğlu, Salim Bilici, Mehmet Melek

Department of Thoracic Surgery, University of Yuzuncu Yil, Van, Turkey; Department of Thoracic Surgery, University of Yuzuncu Yil, Van,
Turkey; Van State Hospital Department of Thoracic Surgery, Van, Turkey; Department of Pediatric Surgery, University of Yuzuncu Yil, Van,
Turkey; Department of Pediatric Surgery, University of Yuzuncu Yil, Van, Turkey.

Received July 29, 2011; accepted August 22, 2011; Epub September 15, 2011; published September 30, 2011

Abstract: Objective: Clinical approach and therapeutic methods are important in cases with complicated hydatid cysts of the lung. This
study was designed to retrospectively investigate cases with hydatid cysts, thereby discussing diagnostic methods, treatment
modalities, and rates of morbidity and mortality in line with the literature. Methods: 176 cases with perforated hydatid cysts, who
presented to our clinic and underwent surgery between 2003 and 2011, were included in the study. There were 71 (40.34%) females
and 105 males (59.66%) with a mean age of 27.80±14.07. The most common symptom was dyspnea (44.31%) and the most common
radiological finding was the water lily sign (21.02%). 88.06% of the cases were surgically treated by Cystotomy+closure of bronchial
opening+ capitonnage, 3.97% by wedge resection, 4.54% by segmentectomy and 3.40% by lobectomy. Results: The cysts exhibited
multiple localization in 24 cases (13.63%), bilateral localization in 14 cases (7.95%), with the most common localization (43.75%)
being the right lower lobe. While the hydatid cyst rupture occurred due to delivery in three (1.70%), trauma in 11 (6.25%, and iatrogenic
causes in seven (3.97%) cases, it occurred spontaneously in the rest of the cases (88.08%). Fourteen of the cases with spontaneously
occurring rupture (7.95%) were detected to have received anthelmintic treatment for hydatid cyst during the preoperative period
(albendazole). The rate of morbidity was 27.27% and the rate of mortality was 1.13% in our study. Two cases recurred during a one-
year follow-up (1.13%). Conclusion: Hydatid cyst rupture should be considered in the differential diagnosis of cases with pleural
effusion, empyema, pneumothorax and pneumonia occurring in endemic regions. Symptoms occurring during and after perforation
lead to errors in differential diagnosis. Performing the surgery without delay favorably affects postoperative morbidity and mortality.
While parenchyma-preserving surgery is preferential, there is a need for resection in perforated hydatid cysts.  (IJCEM1107004).

Key words: Hydatid cyst, rupture, management

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Address all correspondence to:
Dr. Ufuk Cobanoglu
Medical school
University of Yuzuncu Yil
Van, Turkey, Zip: 65100
Tel:+90-432  215 0473
fax: +90-432 2168352
E-mail: drucobanoglu@hotmail.com