[Our clinical experience and follow-up results in hydatid cyst cases: a review of 393 patients from a single center]

Factors associated with hospital length of stay in patients with thoracic hydatid cyst disease undergoing surgical intervention: a retrospective study

BACKGROUND

Hydatid cyst (HC) frequently affects the lungs, making it the second most common site after the liver. This study evaluated the clinical characteristics, surgical procedures, complications, laboratory findings, and factors influencing hospital length of stay (LOS) in patients undergoing surgery for pulmonary hydatid cysts.

METHODS

This retrospective observational study included adult patients who underwent surgery for lung HC between 2017 and 2021. Data were collected using a standardized checklist covering demographics, medical history, clinical symptoms, laboratory findings, treatment details, surgical characteristics, and risk factors. The primary outcome was LOS, defined as the duration between surgery and discharge.

RESULTS

A retrospective analysis of 214 patients with pulmonary hydatid cysts revealed a male predominance (59.3%; median age, 36 years). The most common symptom was cough (39.3%), followed by chest pain and dyspnea. Right lower lobe involvement (51.4%) and synchronous liver cysts (13.6%) were frequently observed. Elevated erythrocyte sedimentation rate (ESR), eosinophilia, positive serology, prolonged air leak, and fever were correlated with longer LOS. The dominant surgical procedure was cystotomy with capitonnage (95.8%), performed via thoracotomy.

CONCLUSIONS

Most hydatid cysts were located in the right lower lobe, with cough being the most frequent presenting symptom. Thoracotomy and cystotomy with capitonnage were the primary surgical procedures performed. Common postoperative complications included wound infection, empyema, and prolonged air leak. Awareness of factors such as elevated ESR, eosinophilia, positive serology, prolonged air leak, and fever may improve management and reduce hospital LOS.

Lung Hydatidosis Unveiled: A Multisystem Mirage of Pathological Rarity

Lung hydatidosis is a zoonotic infection, primarily caused by Echinococcus sp., and has a significant role in the economy and public health. Canines are the predominant hosts of these parasitic tapeworms. Lungs are the most commonly infected organ after the liver. Hepatic pulmonary blood circulation is mainly reported to transport infection to the lungs. The prevalence of hydatid disease has increased over the past decade. In addition, patients with multi-organ involvement of hydatid cysts have been reported in different parts of the world. Hydatidosis can remain asymptomatic for years after infection in some conditions, especially in cases of splenic hydatidosis. Chest radiography and computed tomography findings can be used to confirm the diagnosis of hydatid disease. Hydatid disease is, in general, managed by pharmacological therapy, but if multi-organ involvement is observed, surgery along with medical management is required. Long-term follow-up is recommended in such cases to check the recurrence of the disease.

[Hydatidosis of psoas muscle revealed by vascular axis compression in lower limb: About one case at the Ibn Sina University hospital, Rabat, Morocco]

Introduction

Hydatidosis is a zoonosis caused by Echinococcus granulosus. It's a real public health problem in Morocco. Muscle localization is unusual, even in endemic countries. We report a rarely described case of a hydatid cyst of the psoas muscle diagnosed in our laboratory.

Case report

The patient was a 32-year-old male, living in a rural area. He reported a contact with dogs. He was admitted in vascular surgery department for left hypochondrium pain, with heaviness of the left lower limb and appearance of varicose veins. Clinical examination has found a huge painful and hard mass of the left flank arriving to the hypogastrium with varicose veins of the left leg. An injected CT scan of the pelvic region showed a 189 x 137 mm cystic mass of the left psoas muscle reflowing left iliac vessels. This suggested hydatid cyst. No other localization was found. Hydatid serology was positive with an ELISA test and an indirect hemagglutination test. The patient underwent surgery to remove the mass. Several white vesicles of a few centimeters were found in the cyst and were sent to the parasitology laboratory. Microscopic examination has confirmed the presence of viable Echinococcus granulosus. The patient received albendazole 400 mg twice daily for only a month and was not seen for follow-up. One year after surgery, he showed the same symptoms of abdominal pain and heaviness. Recurrence of hydatid cysts in the same localization was diagnosed with ultrasound showing two hydatid cysts type 3 according to Gharbi classification.

Discussion

Diagnosis of all hydatidosis localizations is based on epidemiological, clinical, and radiological data and confirmed by serology and parasitological examination of the surgical specimen. Surgery is then a diagnostic and therapeutic tool that cannot be bypassed since it allows the definitive elimination of the parasite and eviction of recurrence if it's well done. Conservative methods are related to recurrent cysts.

Conclusion

Muscle hydatidosis is extremely rare but should not be forgotten when radiological and epidemiological data suggest it. It's a benign infection but can be severe and deadly if not appropriately treated.