Bronchoscopic Diagnosis and Removal of a Ruptured Hydatid Cyst

A novel bronchoscope method (saline injection method) for complete extraction of ruptured pulmonary hydatid cyst

INTRODUCTION

Echinococcus granulosus is an important public health problem in the Mediterranean area. Today's surgery is the principal therapeutic approach for chronic ruptured hydatid cyst removal.

OBJECTIVES

In this paper, a new bronchoscopic method using saline injection is explained as a safe method to remove ruptured pulmonary hydatid cysts. This non-invasive method has no complications and no need to anesthesia and admission. We hope that this novel bronchoscopic method can be a starting point for future advances in the field of pulmonary hydatid cyst treatment methods.

METHODS

Saline injection method by bronchoscopy (M. E. Hejazi Method) RESULTS: We extracted the entire hydatid cysts of both patients by fiber optic bronchoscopy using saline injection method (M. E. Hejazi Method) for the detachment of underlying membrane from cavity wall.

CONCLUSIONS

This bronchoscopic method is minimally invasive, without surgery, anesthesia and hospital admission, the least complication and morbidity as well as is cost benefit in comparison with surgery.

Middle lobe syndrome: a singularly rare presentation of complicated pulmonary hydatid disease

Imaging is crucial to the diagnosis of pulmonary hydatid disease, as it is often the first modality that raises suspicion of the disease. Middle lobe syndrome (MLS) as a presentation of this disease is a distinct rarity. A 45-year-old woman, a never-smoker, presented with cough and streaky haemoptysis. Imaging demonstrated a trapezoidal opacity with its base towards the hilum and contiguous with the right cardiac border. The reformatted sagittal view confirmed the diagnosis of MLS. Fibreoptic bronchoscopy (FOB) revealed an avascular white membranous structure wholly occluding the medial segment of the middle lobe. This was completely removed through gentle suction. Bronchial aspirate revealed hooklets of hydatid and echinococcal serology was positive. Subsequently, three cycles of albendazole were administered with remarkable clinical and radiological improvement. To the best of our knowledge, this is the first detailed description of MLS caused by pulmonary hydatidosis that was completely removed through FOB.