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Hydatid cyst is an infection of animal origin caused by the parasite Echinococcus granulosus and most commonly affects the liver and lungs. It is a disease that produces cysts in various body organs.

  • Although cysts occur most often in the liver and lungs, they can appear in other organs.
  • It is common in rural areas where livestock farming is common.
  • It is more common in people who are in contact with dogs.

These cysts, usually localized in the lower lobe of the lung, pressurize the surrounding organs with the growth of cysts. As a result, it manifests as abdominal pain, respiratory distress, lung infection, edema in the right lower quadrant, biliary tract obstruction, and elevated liver function tests.

This infection is transmitted to humans by the feces of domestic animals such as dogs and by eating the meat of infected animals. Especially the feces of animals that are not free of parasites are a huge risk factor. This disease is more common in people dealing with animal farms.

How is Hydatid Cyst Diagnosed?

Hydatid cyst is easily diagnosed with ultrasound and Computed Tomography (CT). At the same time, echinococcal antibodies can be detected serologically by blood tests, ELISA, and indirect hemagglutination. (by testing the blood)

Hydatid Cyst
Figure 1. Lung hydatid cyst in PA chest X-ray and Thorax Computed Tomography

The Treatment of Lung Hydatid Cysts

  1. The first treatment for hydatid cysts in the lung is surgery.
  2. We prefer medicine treatment for patients who are unsuitable for surgery and have multiple cysts (albendazole). This treatment may take some time. Sometimes, surgery is the first choice, as drug therapy does not destroy the cyst in the patient, or it can be a source of infection in the cavity formed after the cyst is removed. In some cases, when the cyst has burst and spread to the chest cavity, medication is used to prevent the recurrence of the cyst.

What are the Surgery Methods for Hydatid Cysts?

Open Surgery: Thoracotomy, that is, by an incision between the 5th and 6th ribs and reaching the lung. The cysts are removed without bursting and without damaging the lung. It is essential not to burst these cysts while removing them and to prevent them from spreading to the lung cavity in case of a burst. After the removal of the cyst, open bronchi are sutured, and the space formed in the lung is closed so that it does not get infected. Briefly, this operation is called inoculation or capitonage with cystotomy.

Closed–Thoracoscopic Method: Thoracoscopic method, that is, closed surgery with the help of video (VATS), through 2-3 incisions without opening the chest cavity.

Removal of lung hydatid cyst by an incision between two ribs without causing a cyst burst.
Cyst removal from the lung
Removal of hydatid cyst without causing a burst

What are the possible complications after surgery?

Here, the patient's age, general condition, respiratory functions, and the presence of disorders related to other organs (lung, liver, kidney, etc.) increase the risk. The most feared complications are post-operative air leak and increased risk of infection due to prolonged drain stay. Since these situations are known beforehand, they are only seen sometimes, as the surgeon usually takes precautions.

Length of stay in hospital

The average hospital stay after hydatid cyst surgery is 4-5 days.

How to Prevent Hydatid Cyst?

Controlling or preventing hydatid disease in humans relies on controlling or eliminating the disease in dogs.

  • High temperature, E. granulosus egg can be killed with hot water at 60 °C in 10 minutes, at 70 °C in 5 minutes, and at 100 °C in 1 minute.
  • Keep away pets from parasites.
  • Avoid eating the meat of the infected animal.
  • Avoid eating fruits and vegetables that may come into contact with animal feces in open areas.
  • Hand hygiene in people dealing with livestock.
  • Wash the fruits and vegetables before consuming them.
  • Prevent children from contacting animal feces at a young age.

Our Publications About Hydatid Cyst

1. Dincer SI, Demir A, Sayar A, Gunluoglu MZ, Kara HV, Gurses A. Surgical treatment of pulmonary hydatid disease: a comparison of children and adults. J Pediatr Surg. 2006 Jul;41(7)-1230-6. PubMed PMID: 16818054.

https://www.ncbi.nlm.nih.gov/pubmed/?term=dincer%2C+S%C4%B0%2Cadalet+demir+pediatric+surgery+journal

http://www.sciencedirect.com/science/article/pii/S0022346806001928?via%3Dihub

Full Text: http://ac.els-cdn.com/S0022346806001928/1-s2.0-S0022346806001928-main.pdf?_tid=344c1dce-6bbc-11e7-b993-00000aab0f26&acdnat=1500384353_9178fbbc3fed1905dcd3601

2. DİNÇER, Seyyit İbrahim; DEMIR, Justice. Infectious Diseases and Surgical Treatments: Lung Cyst Hydatid. Turkiye Klinikleri Journal of Thorasic Surgery Special Topics, 2011, 4.2: 104-111.
http://www.turkiyeklinikleri.com/article/tr-enfexiyoz-hastaliklar-ve-cerrahi-tedavileri-akciger-kist-hidatik-62200.html

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