Ali-Gamrah and Raidan Aliryany
Al-sabeen teaching hospital for Mother and child care Sana'a university
Introduction:
Hydatid cyst is a parasitosis caused by Taenia echinococcus. It is common in many sheep and cattle raising countries in the Mediterranean, South America, the Middle East, New Zealand and Australia. It particularly affects the rural population (1.2.4.14). The classical treatment of pulmonary hydatid cyst is surgical. The objective of surgical treatment for pulmonary hydatidosis is to eradicate the parasite. Drugs have been used in the treatment of hydatid cysts, but results have been variable. In this article, we present our surgical experience and strategy in the management of pulmonary hydatid disease.
Materials and Methods
We reviewed the records of 67 patients with hydatid cyst between January 2000 and January 2012. (Of these 66 patients, 71 (92.4%) had isolated pulmonary cyst) and 5 (7.6%) also had liver hydatid cysts. Seven patients had bilateral pulmonary cysts.
Intradermal test of Casoni and complement fixation test of Weinberg or eosinophil count for diagnosis were used only in 27 (35%) patients. The preoperative diagnosis was based primarily on chest roentgenograms. Abdominal ultrasound was performed routinely to determine whether liver cysts were present. Computed tomography (CT) scan was performed in patients who did not show diagnostic findings specific for pulmonary hydatidosis on posterior anterior and lateral lung radiographs. In addition, CT scan was performed for early detection of coexistent small cysts and to detect cysts complicated by rupture in the lung. Overall, CT scan was performed in 48 patients. All patients underwent endotracheal intubation. Double-lumen endotracheal tube was used in patients older than 14 years of age. Posteriolateral thoracotomy ,thoracoscopy and median sternotomy was performed. The thoracotomy wound and lung, apart from the area containing the cyst, were covered with packed gauzes
