Ruptured hydatid cysts of the lung in children: clinical review and results of surgery

Background. Rupture of a hydatid cyst may cause some unique problems, especially in children. Methods. Sixty-three children with a total of 68 ruptured lung hydatid cysts were operated on between 1980 and 2000. Mean age was 12.3 years (range, 1 to 15 years). Radiographic findings were hydropneumothorax (20.6%) and air-fluid level (19%). Mean follow-up was 19.3 months. Results. Transthoracic needle aspiration was responsible for the rupture in 3 children. The interval between cyst rupture and operation was less than 24 hours in 10 patients (15.9%), 1 to 4 days in 36 (57.1%), and more than 4 days in 17 (27%). Resection rate was 22.1%. The most frequent operative method was cystotomy and capitonnage (38%). Morbidity was 25.4% (extended air leak 5, empyema 3, bronchopleural fistula 3, atelectasis 3, pneumonia 2). Mortality was 4.7% (hemoptysis 1, pneumonia and sepsis 1, aspiration of hydatid material 1). Morbidity and mortality seem to be more frequent in late cases. Conclusions. Early surgical intervention with single-lung ventilation and maximum parenchyma preservation are recommended.