Right Upper Lobectomy for a Huge Intact Pulmonary Hydatid Cyst in a Child.

1. ‫الرحيم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬
Right Upper Lobectomy for a Huge
Intact Pulmonary Hydatid Cyst in a
Child
Prof. Abdulsalam Y Taha
College of Medicine
University of Sulaimani
2022 1

2. The Case
 A 7-years old boy was admitted to
Sulaymaniyah Teaching Hospital,
Sulaymaniyah, Region of Kurdistan,
Iraq on 4th of Feb 2010 because of
anorexia and weight loss of one year
duration. On examination, he was
pale and small for his age. Chest
examination revealed bilateral
wheeze.
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4. The chest radiograph showed a huge rounded
opacity occupying right upper and middle zones
with small ill defined opacities in the left middle
zone.
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5. Ct scan of chest and abdomen displayed an intact cyst
in right lung, multiple small ruptured and intact cysts in
left lower lobe and a small cyst in the liver.
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Courtesy of Prof. Abdulsalam Y Taha

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Courtesy of Prof. Abdulsalam Y Taha

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Courtesy of Prof. Abdulsalam Y Taha Courtesy of Prof. Abdulsalam Y Taha

11. The Case…
 The patient was prepared for surgery on the
right chest. Right posterolateral 5th space
thoracotomy was done. A huge intact cyst
completely destroying the RUL with adhesions
to chest wall was found. The cyst was
surrounded by packs soaked in Povidone iodine.
The cyst’s contents were removed by aspiration
and evacuation method. Then right upper
lobectomy was performed in the routine way.
Hemostasis and aerostasis were secured. Two
chest drains were placed. The chest wall was
closed in layers. The postoperative course was
smooth. 11

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16. Comment
 This was a case of multiple bilateral
pulmonary and liver hydatid cysts in a
child. Multiple pulmonary hydatid cyst is
not rare in areas in which hydatid disease
is highly endemic [1].
 Although the lung is next to liver in
involvement with hydatid disease, it is
operated upon first when both organs are
involved. Untreated PHC may rupture
during surgery and threatens the life of
the patient. 16

17. Comment…
 If bilateral intact PHC are
encountered, surgery is offered for the
bigger cyst first. However, if one cyst
is already ruptured, surgery is done on
the intact cyst first to avoid the
complications of its sudden rupture.
 Lobectomy was necessary in this case
due to the irreversible damage of the
RUL produced by the huge size of the
cyst.
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18. Bibliography
[1] Sajiai H, Rachidi M, Aitbatahar S,
Serhane H, Amro L. Kyste hydatique
pulmonaire: double localisation
pulmonaire apicale inhabituelle. A propos
d’un cas [Pulmonary hydatid cyst: unusual
double apical location. About a case]. Pan
Afr Med J. 2016 Nov 14;25:159. French.
doi: 10.11604/pamj.2016.25.159.10357.
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