Giant pulmonary hydatid cyst in children

Area of Science:

• Pediatric Surgery
• Infectious Diseases
• Radiology

Background:

• Hydatid disease remains endemic in Tunisia, frequently affecting young individuals under 40.
• Pulmonary hydatid cysts (PHC) are predominant in children, with one-third of all cases occurring in this age group.
• Understanding the specific management of pediatric PHC, especially giant cysts, is crucial for optimizing outcomes.

Purpose of the Study:

• To define the management particularities of pediatric pulmonary hydatid cysts (PHC).
• To characterize giant PHC (≥10 cm) in children.
• To identify predictive factors for complications in pediatric PHC.

Main Methods:

• Retrospective study of 105 children (<16 years) with surgically confirmed PHC between 1999 and 2019.
• Cysts categorized as giant (≥10 cm) or non-giant.
• Analysis of clinical presentation, diagnostic methods (ultrasonography, CT scan), surgical procedures, and post-operative outcomes.

Main Results:

• Giant cysts were found in 22.9% of patients and were significantly associated with dyspnea and thoracic pain.
• Surgical interventions included cystectomy (59%), pericystectomy (18%), and pulmonary resection (23%), with resection more frequent in complicated and giant cysts.
• Post-operative complications and prolonged hospital stays were more common in complicated and giant PHC.

Conclusions:

• In endemic areas, combining thoracic radiography and ultrasonography is recommended for effective, accessible pediatric PHC diagnosis.
• Giant and complicated PHC can lead to significant lung damage, necessitating extensive surgery and increasing complication risks.
• Effective management strategies are vital to reduce morbidity and healthcare costs associated with pediatric PHC.