Percutaneous treatment of pulmonary hydatid cysts

To evaluate the safety and efficacy of percutaneous drainage of pulmonary hydatid cysts.

Eleven pulmonary hydatid cysts in eight patients were drained percutaneously after 1-2 years of treatment with mebendazole (50 mg/kg/day). Percutaneous needle aspiration was carried out under ultrasound (US) in six patients and computed tomography (CT) in two patients. Nine cysts were close to, and two cysts were distant from the thoracic wall. After aspiration, hypertonic (15%) saline solution was instilled for up to 35% of the estimated volume of the cyst and aspirated 5-10 min later. Follow-up ranged from 8 to 31 months (mean 16.3 months).

Neither anaphylactic shock nor death occurred in any of the eight patients. One patient developed fever, ipsilateral hydropneumothorax, and contralateral pleural effusion. One patient suffered from fever, pneumothorax, and abscess and was treated surgically; one developed fever and dyspnea. The volume reduction during follow-up was 47%-93%. The cystic contents turned into a pseudotumor appearance with a thick irregular contour on CT and higher Hounsfield units. On US, the cysts showed a heterogeneous content with internal echoes representing detached and degenerated membranes, and the fluid content almost completely disappeared.

We believe that percutaneous therapy of pulmonary hydatid disease is an effective alternative to surgical treatment in patients who have failed medical therapy.