ANALYSIS OF PRIMARY INTRATHORACIC EXTRAPULMONARY HYDATID CYSTS A RARE CLINICAL ENTITY

Extrapulmonary Hydatid Cysts

Authors

  • Manzoor Ahmad Post Graduate Medical Institute, Lady Reading Hospital Peshawar, Pakistan
  • Muhammad Kaleem Ullah Post Graduate Medical Institute, Lady Reading Hospital Peshawar, Pakistan
  • Muhammad Imran Post Graduate Medical Institute, Lady Reading Hospital Peshawar, Pakistan
  • Aamir Bilal Post Graduate Medical Institute, Lady Reading Hospital Peshawar, Pakistan
  • Muhammad Abid Khan Post Graduate Medical Institute, Lady Reading Hospital Peshawar, Pakistan
  • Syed Zahid Ali Shah Post Graduate Medical Institute, Lady Reading Hospital Peshawar, Pakistan
  • Abdul Baseer Post Graduate Medical Institute, Lady Reading Hospital Peshawar, Pakistan
  • Baha uddin Post Graduate Medical Institute, Lady Reading Hospital Peshawar, Pakistan
  • Faridullah Khan Post Graduate Medical Institute, Lady Reading Hospital Peshawar, Pakistan

Keywords:

Albendazole, Extrapulmonary, Hydatid cyst, Intraparenchymal cyst

Abstract

Objective: To evaluate the anatomic location of cysts, operative characteristics of intrathoracic extrapulmonary hydatid cyst and to determine the outcome of aggressive surgical interventions.

Study Design: Case series.

Place and Duration of Study: Thoracic Surgery Unit Lady Reading Hospital Peshawar from 1st July 2008 to 30th June 2011.

Methodology: All patients admitted to Thoracic unit from July 2008 to June 2011 with intra thoracic hydatid cysts were evaluated prospectively as to age, sex, symptoms, diagnostic procedures, anatomic location of cysts, surgical procedures, complications, and outcomes. Chest radiography, computed tomography, and thoracic and abdominal ultrasonography had been performed preoperatively in all of them. Bronchoscopy and spirometry was also performed in all patients for assessment and operability. Echocardiography had been used in 2 patients to determine the contiguity of the cyst to the pericardium. Cystectomy and wide resection were the chief operative procedures. Most of the patients were having cysts in the pulmonary parenchyma only 10 patients had intrathoracic cysts in extrapulmonary locations. This group of patients was included in the study. We excluded patients who had a parenchymal cyst that had perforated to the pleura, myocardial hydatid and patients who had experienced transdiaphragmatic transmission.

Results: Total of 149 patients were operated for hydatid cystectomy, out of these 139 patients had pulmonary hydatid and 10 patients had intrathoracic extrapulmonary hydatid cysts. These 10 patients constitute our study group; out of these 7 were men and 3 women whose mean age was 39.14 ± 16.8 years (range, 16–69 years). Eight (80%) of these were symptomatic, most commonly with chest pain, two patients were asymptomatic. There were 2 (20%) mediastinal hydatid, 2 (20%) diaphragmatic, 2 (20%) pericardial, 2 (20%) oblique fissure, and 1 (10%) each in chest wall and pleural hydatid in our study. Albendazole (10 mg/kg) was prescribed to all patients for as long as 3 months postoperatively. No complication, recurrence, or death occurred during the follow up period of 13 ± 15.4 months (range, 2–36 months).

Conclusion: The extrapulmonary location of Hydatid cysts within the thorax is very rare. This rarity may cause difficulties in diagnosis. To avoid recurrence, it is necessary to resect the affected tissues completely and an anthelmintic medical regimen post operatively.

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Published

28-02-2015

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Section

Original Articles

How to Cite

1.
Ahmad M, Ullah MK, Imran M, Bilal A, Khan MA, Shah SZA, et al. ANALYSIS OF PRIMARY INTRATHORACIC EXTRAPULMONARY HYDATID CYSTS A RARE CLINICAL ENTITY: Extrapulmonary Hydatid Cysts. Pak Armed Forces Med J [Internet]. 2015 Feb. 28 [cited 2024 Dec. 14];65(1):3-7. Available from: https://pafmj.org/PAFMJ/article/view/625