Pneumonectomy for a hepatic hydatid cyst ruptured in the thorax: A case report

Hydatid cyst disease is a parasitic infection, primarily affecting the liver. Intrathoracic rupture of a liver hydatid cyst is a rare but severe complication that poses significant therapeutic challenges.

A 45-year-old woman diagnosed with hepatic hydatid cyst ruptured in the thorax which caused serious damage to the lung parenchyma and posed a therapeutic challenge. We decided to operate on both locations in the same intervention. Given that the lung was completely destroyed, a pneumonectomy was necessary. Due to critical condition, we decieded to postpone the abdominal phase. On the 4th postoperative day, transdiaphragmatic rupture of the hepatic cyst was suspected. The patient was urgently reoperated. Consequently, resection of a large cyst in the hepatic dome was performef with the excision of another cyst involving the liver. Via the same posterolateral thoracotomy, the pleural cavity was thoroughly irrigated. The postoperative course was uneventful.

Intrathoracic rupture of hepatic hydatid cyst is a rare but serious complication. Aged cysts of the hepatic dome are the greatest providers of this complication. Damage to the pleura, pulmonary parenchyma, and bronchi can be severe. In the lung, lesions range from simple hepatization to total destruction of the lung tissue as observed in our case. The choice of the surgical approach remains controversial.

Intrathoracic rupture of the liver hydatid cyst is a rare but potentially serious complication. The morbidity and mortality remains high. This highlights the necessity of a multidisciplinary surgical approach and the importance of prevention.