Spontaneous rupture of giant hydatid cyst of lung into left bronchus: Preoperative diagnosis and treatment

Sagar Eknath Rathi, Sandya P, Atul Jivan Bonde, Krishna Kumar KV, Krishna M

Pdf Page Numbers :- 72-76

Sagar Eknath Rathi^1,*, Sandya P¹, Atul Jivan Bonde¹, Krishna Kumar KV² and Krishna M³

¹Department of Pediatrics, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India

²Department of Cardiovascular Surgery, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India

³Department of Anaesthesia, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India

*Corresponding author: Dr. Sagar Eknath Rathi, DNB Resident, Department of Pediatrics, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India. Mobile: 9908183708; Email: sagarrathi07@gmail.com

Received 15 December 2017; Revised 22 February 2017; Accepted 01 March 2017; Published 10 March 2017

Citation: Rathi SE, Sandya P, Bonde AJ, Kumar KVK, Krishna M. Spontaneous rupture of giant hydatid cyst of lung into left bronchus: Preoperative diagnosis and treatment. J Med Sci Res. 2017; 5(2):72-76. DOI: http://dx.doi.org/10.17727/JMSR.2017/5-14  

Copyright: © 2017 Rathi SE et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Introduction: Hydatid disease is a parasitic infestation caused by Echinococcus granulosus in which human is accidental intermediate host. Lung is the most common site involved in children unlike adults, where liver is involved.

Case report: 13-year-old girl who was asymptomatic, was found to have reduced air entry on left side during health checkup. Chest radiography (CXR) was suggestive of radio-opaque lesion obscuring left cardiac border and left dome of diaphragm. CT chest report was suggestive of intrapulmonary hydatid cyst. However, few hours after admission, she developed anaphylactic reaction which was managed successfully with adrenaline and steroids. Repeat chest readiograph was suggestive of decreased opacity, air fluid level noticed on dependent part of left lung. Rupture of the cyst was suspected. She underwent left thoracotomy and evacuation of hydatid cyst was done. Intra-operative findings were suggestive of broken endocyst, thoracic cavity filled with fluid with multiple bronchial openings.

Conclusion: Hydatid cyst despite of its thick covering layers, undergoes spontaneous rupture occasionally. Anaphylactic shock due to rupture of cyst is a life threatening complication.

Keywords: hydatid cyst; rupture; anaphylactic reaction; enucleation of cyst