Hydatid disease of the lung

The author describes his experience with pulmonary hydatid disease in children. Unlike adults, pulmonary localization is common in children, up to 50% of the total cases involved. The following rules have been established for the correct treatment of this condition: 1. an accurate approach 2. sterilization and evacuation of the parasite 3. treatment of the adventitial layer of the membrane. The reason for the evacuation of the parasite is that it migrates when the adventitia is broken. The operation of "hydatid birth" is therefore recommended. This consists of the removal of the whole, intact cyst. Another method is sterilization of a chemical scolicide followed by surgical aspiration. This is a safer method because it avoids the risk of dissemination, but produces more postoperative morbidity and a longer stay in hospital. There are conservative and radical methods of treating the adventitia. In children conservative methods are commonly used. Recently a new chemotherapy with Mebendazole has been very effective in secondary hydatid disease in mice. It has been used at the Children's Hospital in Buenos Aires in a group of children with good results, although it is as yet too early to establish the real effectiveness of this treatment. It would represent a valuable alternative for disseminated hydatid cysts or those in inaccessible sites and would reduce the risk of surgical dissemination. Surgical treatment is indicated for noncomplicated cysts, it is essential for infected cysts and can be delayed when cysts are opened into the bronchi.