A tactics of surgical treatment of a lung echinococcal cyst ruptured into the bronchus

Abstract

Relevance. The most severe complication of pulmonary echinococcosis is cyst rupture with contaminated leakage into the tracheobronchial tree.Material and methods. A 10-year-old boy was admitted to the clinic with diagnosis of fibroatelectasis of the lower lobe of the right lung. Anamnesis revealed that the boy was not well for more than 2 years. His treatment in several hospitals did not have any positive effect. Fibrobronchoscopy was performed during which a fragment of chitinous membrane was found in the orifice of lower lobe bronchus. Histological examination confirmed pulmonary echinococcosis.Results. A hydatid cyst in the projection of 9th and 10th segments of the lower lobe was revealed after thoracotomy on the right. Cystectomy with capitonage of the residual cavity was performed. Early postoperative period was uneventful. The child had conventional etiotropic therapy. A follow-up examination in 2 years with radiological and serological findings revealed no relapse of the disease. Child’s development corresponded to his age.Conclusion. The description of this case indicates that it is extremely important to have a detailed information about disease manifestations. In case of long-lasting lung disease , a diagnostic tracheobronchoscopy is recommended since radiological signs in complicated pulmonary echinococcosis may be not informative.