The researchers investigated the occurrence of thoracic rupture of 123 cases of hepatic hydatidosis, and reported their findings in the December issue of the Annals of Thoracic Surgery.
Hydatid disease is often endemic in countries with poor environmental sanitation, and in geographic areas where interaction between humans and animals is common.
Pulmonary complications result from the proximity of hydatid cysts in the liver and the diaphragm.
The medical records of the patients who had established hydatid disease manifesting abnormal chest roentgenograms were retrospectively analyzed for the period January 1990 to December 1999.
Chest roentgenogram and abdominal ultrasound provided a correct preoperative diagnosis in 108 patients (88%).
|Outcomes after thoracotomy:|
| Annals of Thoracic Surgery |
Expectoration of bile, demonstration of fistula by ultrasound, expectoration of cyst contents, and additional ultrasound or imaging findings were the criteria used to establish the preoperative diagnosis.
The remaining 15 cases were confirmed at operation.
Men outnumbered women nearly 3:1 and mean age was 36 years.
Pulmonary resection was performed in 67 of the cases.
The team found that 68 patients presented with a bronchobiliary fistula (55%).
Morbidity and mortality rates were 15% and 9%.
Dr El Hassane Kabiri, of the Ibn Sina University Hospital, Rabat, concluded on behalf of the group, "Thoracotomy offers adequate simultaneous access to both the chest and hepatic lesions with acceptable morbidity and mortality.
"Endoscopic sphincterotomy undertaken preoperatively is useful in reducing biliary complications."