Hydatid disease of lung

Abstract

Background:Hydatid cyst is zoonosis caused due to Echinococcus species - Cestode parasite, Echinococcus granulosus. In developing countries like India, Iran, China and Mediterranean countries it is still remains a major problem. It can involve any organ and can mimic almost any pathological condition. Complication associated rather than disease itself, are difficult to treat. Objectives of the study was to study the clinical presentation of hydatid disease of lung, its management and its complications.

Methods: All patients diagnosed as hydatid disease mainly by X-ray, USG or CT scan and then treated either operatively or non-operatively were included in this study. Pulmonary function test and pre-operative incentive spirometry started.  Patients were operated after a preoperative Albendazole therapy for 28 days in dose of 10mg/kg and postoperatively all patients were put on Albendazole three course of 28 weeks each with 1 week gap in between. The choice of surgical procedure was guided by site, size of the cyst and associated complications. Thorough post-operative care and chest physiotherapy and nebulization started. The patients were followed up for a period of 6 months.

Results:Total 26 patients were studied in a period of 3 years. Maximum number of patients presented with cough (83.34%). X-ray was most commonly used diagnostic modality, and CT scan was done in all patients for confirmation of diagnosis. The mostly right side was involved in all patients. Most of the lung cysts were single and unilateral. Total cystectomy with intercostal drainage was the most common modality of treatment. Broncho-pleural fistula with pus discharge was the most common intra-operative complication. All the patients had respiratory complications in postoperative period which are managed conservatively.

Conclusions:Lung Hydatid is a severe systemic manifestation of Hydatid disease. Complications are life threatening. Management of lung hydatid disease requires both surgical and intensive respiratory management. With recent advances in management, outcome has improved over years.