Pulmonary Echinococcosis Surgery

We present an analysis of the results of surgical treatment of 182 patients with pulmonary echinococcosis (126 patients with uncomplicated and 56 with complicated pulmonary echinococcosis). Of these, only in 23 patients out of 25 planned, it was possible to carry out echinococcectomy purely thoracoscopically through trocar punctures. In 134 cases, videothoracoscopic echinococectomy was performed using a mini-access. In case of bilateral localization of cysts, stage-by-stage operations were performed in 7 patients, and in 3 (36.36%) cases - single-stage echinococcectomy. Echinococcectomy from the lung was performed in 25 patients using a wide thoracotomy approach. In 134 cases, videothoracoscopic echinococectomy was performed using a mini-access. In case of bilateral localization of cysts, stage-by-stage operations were performed in 7 patients, and in 3 (36.36%) cases - single-stage echinococcectomy. Echinococcectomy from the lung was performed in 25 patients using a wide thoracotomy approach. All patients underwent anterolateral thoracotomy. Basically (97.67%) performed organ-preserving operations with the elimination of the residual cavity in the light suture plastics in various modifications. In 2 patients with marginal location and pneumocirrhosis, marginal resection of the lung with an echinococcal cyst was performed.With combined echinococcosis of the lungs and liver, 10 patients were operated on. 6 patients underwent surgical interventions on the lungs and liver through separate approaches at the same time. The use of minimally invasive techniques for pulmonary echinococcosis is possible in more than 2/3 of patients.

A tactics of surgical treatment of a lung echinococcal cyst ruptured into the bronchus

Relevance. The most severe complication of pulmonary echinococcosis is cyst rupture with contaminated leakage into the tracheobronchial tree.Material and methods. A 10-year-old boy was admitted to the clinic with diagnosis of fibroatelectasis of the lower lobe of the right lung. Anamnesis revealed that the boy was not well for more than 2 years. His treatment in several hospitals did not have any positive effect. Fibrobronchoscopy was performed during which a fragment of chitinous membrane was found in the orifice of lower lobe bronchus. Histological examination confirmed pulmonary echinococcosis.Results. A hydatid cyst in the projection of 9th and 10th segments of the lower lobe was revealed after thoracotomy on the right. Cystectomy with capitonage of the residual cavity was performed. Early postoperative period was uneventful. The child had conventional etiotropic therapy. A follow-up examination in 2 years with radiological and serological findings revealed no relapse of the disease. Child’s development corresponded to his age.Conclusion. The description of this case indicates that it is extremely important to have a detailed information about disease manifestations. In case of long-lasting lung disease , a diagnostic tracheobronchoscopy is recommended since radiological signs in complicated pulmonary echinococcosis may be not informative.

Pulmonary echinococcosis: A rare pseudotumour of the lung

Cystic echinococcosis is a widely endemic helminthic disease worldwide but occurs only rarely in Central Europe. Humans are infected as ‘aberrant’ hosts by Echinococcus granulosus and develop cysts in numerous different organs. 20%–30% of the affected individuals develop hydatid disease in the lungs with associated complications including pleuritis, lung abscess and pneumothorax. Radiologically, the pulmonary lesions of cystic echinococcosis occasionally pose difficulties in the differential diagnosis of primary lung carcinoma or metastatic disease and vice versa. Herein we report on a case of pulmonary hydatid disease in a 25-year-old Iraqi male presenting with a cystic lesion of the lung associated with thoracic pain and involuntary weight loss. Despite of its rare occurrence in Central Europe, clinicians, radiologists and pathologists should be aware of this entity and its pulmonary manifestations. During frozen section examination, imprint cytology specimens may facilitate the detection of the pathogens.

Cystic echinococcosis: An attraction for fungal and bacterial pulmonary infections

Lung hydatidosis can remain latent for a long time, and symptoms may occur when the cysts grow to a certain size or when symptoms arise secondary to complications such as rupture or superinfection with bacterial organisms or fungi. A variety of signs denoting different appearances of complicated and/or uncomplicated pulmonary hydatid cysts have been described on chest radiographs and computed tomography scans. Aspergillosis is one of the most common fungal infections associated with pre-existing pulmonary cavities. The coexistence of aspergillosis and hydatid cyst is rare. Citrobacter infections usually occur in patients with underlying co-morbidities or immunosuppression. We presented a case of pulmonary echinococcosis with multiple bilateral cysts in which several consecutive episodes of cysts rupture and concomitant Aspergillus and Citrobacter pulmonary infections have been documented.