Hydatid disease of the lung
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Pulmonary hydatid disease in children requires specific surgical approaches like "hydatid birth" for intact cyst removal. Chemotherapy with Mebendazole shows promise for complex cases, offering a safer alternative.
Area of Science:
- Pediatric Surgery
- Parasitology
- Infectious Diseases
Background:
- Pulmonary hydatid disease is common in children, unlike in adults.
- Accurate diagnosis and treatment are crucial for managing this parasitic infection.
Purpose of the Study:
- To outline established treatment protocols for pediatric pulmonary hydatid disease.
- To discuss surgical techniques and emerging chemotherapeutic options.
Main Methods:
- Surgical intervention focusing on parasite sterilization, evacuation, and adventitial layer management.
- Evaluation of "hydatid birth" (intact cyst removal) and chemical scolicide aspiration.
- Assessment of Mebendazole chemotherapy in pediatric cases.
Main Results:
- "Hydatid birth" is recommended to prevent parasite migration.
- Chemical scolicide aspiration is safer but increases morbidity and hospital stay.
- Mebendazole shows positive preliminary results in secondary and disseminated hydatid disease.
Conclusions:
- Pediatric pulmonary hydatid disease necessitates tailored surgical strategies.
- Chemotherapy with Mebendazole presents a potential alternative for complex or disseminated cases.
- Further research is needed to confirm the long-term efficacy of Mebendazole.
Abstract:
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.