J Pediatr Surg 2019 Mar 19. Epub 2019 Mar 19.
Department of Pediatric, Children Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco.
Objective: The objective of this study was to describe the role of surgical management of ruptured hydatid cysts into the pleural cavity in children. A review of the management of patients with intrapleural rupture of pulmonary hydatid cysts in children at our center was performed.
Materials And Methods: A retrospective chart review was performed on all children who developed intrapleural rupture of a hydatid cyst in the lung. Patients with intrapleural rupture from other locations (liver, mediastinum, diaphragm, kidney) were excluded.
Results: In these 19 patients, there were 11 males and 8 females with a mean age of 9.4 years (range 7-16 years). Different clinical symptoms, biological, and imaging data allowed the diagnosis. The surgical approach consisted of a posterolateral thoracotomy and decortication in all patients. In addition, different procedures were needed for the pulmonary lesion according to the degree of lung destruction. Radical resections were required in four cases, including lobectomies (n = 1) and segmentectomies (n = 3). Conservative treatment was possible in 15 patients (simple capitonnage and bronchial fistula closure). Post-operative complications occurred in 2 cases (10.5%), including one pyothorax with a prolonged air leak and one wound infection. There were no postoperative deaths. There was no recurrence of thoracic hydatid disease in postoperative follow-up ranging from 1 to 3 years (mean: 2 years).
Conclusion: Intrapleural hydatid cyst rupture may be prevented by early treatment of simple forms to avoid increased morbidity.
Level Of Evidence: Level IV.