Secondary pleural hydatidosis: complication of abdominal hydatid cysts

Abstract

Introduction: The hydatid cyst is a parasitic disease, which is still endemic around the Mediterranean notably in Tunisia. Pleural involvement is mainly caused by rupture of abdominal or pulmonary hydatid cysts. There is no consensus regarding the management of this disease.

Aims and objectives: The objective of our study was to describe the epidemiological, clinical and radiological profile of Secondary pleural hydatidosis (SPH) due to abdominal hydatid cysts and the results of surgery.

Methods: Descriptive and retrospective study including seventeen patients operated on for SPH due to abdominal hydatid cysts in the thoracic surgery department of the Abderrahmane Mami hospital in Ariana (2005-2020).

Results: The average age of the patients was 46 years. 65% of the patients were operated on for hepatic hydatid cysts. The main clinical signs noted were chest pain (65%), abdominal pain (18%), and blood-streaked sputum (12%). The thoraco-abdominal CT-scan showed SPH (100%), hepatic hydatid cyst (94%) and a diaphragmatic breach (41%). All our patients were operated on using a posterolateral thoracotomy approach. We performed decortication in 35% of the cases and cystectomy (82%). A resection of the protruding dome via a transdiaphragmatic incision was done in height cases. Postoperative courses were uneventful (82%) and 18 % of the patients had prolonged air leaks. At discharge, all our patients took albendazole.

Conclusions: Secondary pleural hydatidosis is frequently seen after rupture of abdominal cyst in the pleural cavity. The treatment of both lesions is possible via a thoracotomy and a transdiaphragmatic incision that allows the treatment of thoracic cysts and hepatic lesions at once.