Pleural complications of hydatid disease (Echinococcus granulosus)

Seventy patients with hydatid disease were referred to our institution during the last ten years. In all cases the clinical and radiological findings were confirmed by pathology. In three of seventy patients pleural complications were found consisting in hydropneumothorax and a life-threatening tension pneumothorax following pleural perforation of ruptured pulmonary hydatid cysts in two cases and prolapsed hepatic hydatid cyst in one case. Bronchial rupture with anaphylactic symptoms and collapse occurred in one patient. In another, the pathologic anatomic examination gave clues of an old bilio-bronchial fistula. In all cases, lobectomies had to be carried out due to involvement and extensive destruction of surrounding lung tissue. CT visualized and localized the lesion and was helpful for a correct diagnosis. Ruptured and infected hydatid cysts are often confused with tumors and/or abscesses or empyema. Early recognition is important to prevent complications and if dissemination has occurred, to combine surgery with mebendazole or albendazole treatment.