Surgical approach of pulmonary hydatidosis in childhood

Gastrointestinal helminths of stray dogs in Erzurum province: prevalence and risk to public health

Dogs have an important role in public health due to their close contact with humans and living in common areas. This study was aimed to investigate the presence and prevalence of gastrointestinal system helminths in stray dogs in Erzurum province. Gastrointestinal helminth eggs were detected in a total of 190 out of 446 (42.6%) in stray dogs in Erzurum province. In the study, taeniid eggs (17.71%, 79/446), T. canis (16.82%, 75/446), T. leonina (12.78%, 57/446), Linguatula spp. (4.48%, 20/446), spiny-headed worms (2.91%, 13/446), hookworms (2.69%, 12/446), Alaria spp. (1.12%, 5/446) and Trichuris spp. (0.22%, 1/446) eggs were observed. In addition, proglottid structures of Mesocestoides spp. (3.14%), Taenia spp. (2.69%), and D. caninum (1.12%), adults of Alaria spp. (0.22%), T. canis (0.22%), and T. leonina (0.22%) were detected. According to the results of the study, zoonotic parasites including taeniid cestodes, T. canis, Linguatula spp., spiny-headed worm, hookworm, Alaria spp., and Trichuris spp. were common in stray dogs in the province. Public health risks can be reduced by regular deworming of dogs, proper management of the process, prevention of environmental contamination with dog feces, and proper enforcement of sanitation protocols.

Primary Disseminated Hydatid Disease Involving Multiple Organs in a Pediatric Patient: A Rare Case Report

Hydatid disease is a parasitic infestation by Echinococcus genus of tapeworm, resulting from ingestion of tapeworm eggs and leading to formation of cysts predominantly in the liver and lungs. Multiorgan involvement in children is unusual. We present a case of a 12-year-old female with multiple organ involvement. Patient had history of abdominal pain, breathlessness, irritability and vomiting. Plain radiograph showed a large ovoid calcific lesion projected over the liver. Abdominal sonography demonstrated multiple hydatid cysts in the liver, spleen and left kidney. Ultrasound findings were further confirmed by contrast-enhanced computed tomography that showed additional hydatid cysts in bilateral lungs. All accessible cysts were excised on laparotomy. Cystic hydatid disease should be suspected in all pediatric patients with multiple cystic lesions, especially in endemic areas.

Clinical features and treatment of bronchial rupture of pulmonary hydatid cyst in children: a retrospective study of 36 patients

BACKGROUND

The aim of this study was to review the clinical symptoms, radiological data, surgical techniques, and postoperative complications associated with bronchial rupture of pulmonary hydatid cysts in children and evaluate the results of surgical treatment.

MATERIALS AND METHODS

A retrospective study of 40 surgical procedures performed for pulmonary hydatid cyst ruptured in the bronchial tree in 36 children (22 boys and 14 girls), aged between 7 and 18 from January 2009 to December 2019.

RESULTS

The study included 36 patients with a mean age of 14.7. Most symptoms were cough (63.9%), chest pain (38.9%), hemoptysis (33.3%), and hydatid vomiting (22.2%). Chest X-ray, chest CT scan and abdominal echography was performed in all cases. Surgical approach was posterolateral thoracotomy in all cases. Conservative treatment was possible in 35 patients (97.2%) through cystotomy in 25 cases, pericystectomy in 11 cases, and lobar resection in 1 case (2.8%). Average operative time was 103 min (range: 53 and 185 min) and mean postoperative hospital stay was 5.9 days. The postoperative complications occurred in 4 (11.1%): atelectasis (N  =  2), wound site infection (N  =  1), and prolonged air leak (N  =  1). There was no postoperative mortality. After an average follow-up of 39 months there was no recurrence.

CONCLUSION

Ruptured hydatid cyst of the lung into the bronchus. Must be surgically treated and carefully due to the risk of per-operative bronchial flooding. Conservative surgical procedures with precise closure of the bronchial fistulas and capitonnage can complete removal of the cyst with low complications.

The diagnostic value of fiberoptic bronchoscopy in ruptured lung hydatid cysts

Background

This study aims to evaluate the diagnostic yield of fiberoptic bronchoscopy in ruptured pulmonary hydatid cysts indistinguishable from pulmonary masses on imaging techniques.

Methods

Between January 2000 and January 2018, a total of 45 consecutive patients (27 males, 18 females; mean age 46.4±13.5 years; range, 23 to 78 years) who underwent fiberoptic bronchoscopy to establish the definitive diagnosis following radio-diagnostic procedures were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, preoperative diagnostic studies, bronchoscopic findings, and postoperative diagnosis were recorded.

Results

Endobronchial hyperemia (n=42) and purulent secretion (n=34) are the most common findings of bronchoscopy. The most specific finding was the presence of pieces of cystic membranes in 23 patients. Scolices were seen in five patients in bronchial aspirate. In one patient, both pieces of cystic membranes and scolices in bronchial aspirate were detected. The preliminary diagnosis of a hydatid cyst was made based on these findings in 28 patients (62.2%) preoperatively. The definitive diagnosis of a hydatid cyst was confirmed through thoracotomy in all patients.

Conclusion

Bronchoscopy is a particularly valuable method in the definitive diagnosis of ruptured lung hydatid cysts. The definite diagnosis is based on the visualization of the endobronchial membrane during bronchoscopy or scolices in the bronchial aspirate. It can be also used to prevent complications such as bronchial dissemination and asphyxia due to intra-bronchial membrane pieces.

[Combined echinococcosis management in children]

AIM

To analyze the results of diagnosis and treatment of combined echinococcosis.

MATERIAL AND METHODS

The study included 51 children. 40 (78.4%) of them had combined lesion of liver and other organs, 29 - combined echinococcosis of liver and lungs. Echinococcosis of both lungs was observed in 14 children including lesion of liver in 6 cases. Combined echinococcosis of three organs was observed in 5 patients.

RESULTS AND DISCUSSION

Combined echinococcosis in children was associated with uneven growth of parasitic cysts in various tissues. Small cysts were revealed in 15 (37.5%) out of 40 observations of combined lesion of liver and other organs. 7 patients underwent medical therapy for small cysts after previous surgery for medium and large cysts. Rapid growth of remained cysts occurred within 1-3 months between surgical stages. It may be often associated with complications related to remained cyst especially in case of both lungs echinococcosis. There were 6 (11.8%) postoperative complications in 51 patients with combined echinococcosis. Recurrence occurred in 2 (3.9%) children. Deaths were absent.

CONCLUSION

Conservative therapy for small cysts provides 2-fold decrease of operations number and prevents recurrence of the disease. Reduced period between surgical stages up to 11±2 days prevents complications in case of both lungs echinococcosis.

A systematic review of the literature on cystic echinococcosis frequency worldwide and its associated clinical manifestations

A systematic literature review of cystic echinoccocosis (CE) frequency and symptoms was conducted. Studies without denominators, original data, or using one serological test were excluded. Random-effect log-binomial models were run for CE frequency and proportion of reported symptoms where appropriate. A total of 45 and 25 articles on CE frequency and symptoms met all inclusion criteria. Prevalence of CE ranged from 1% to 7% in community-based studies and incidence rates ranged from 0 to 32 cases per 100,000 in hospital-based studies. The CE prevalence was higher in females (Prevalence Proportion Ratio: 1.35 [95% Bayesian Credible Interval: 1.16-1.53]) and increased with age. The most common manifestations of hepatic and pulmonary CE were abdominal pain (57.3% [95% confidence interval [CI]: 37.3-76.1%]) and cough (51.3% [95% CI: 35.7-66.7%]), respectively. The results are limited by the small number of unbiased studies. Nonetheless, the age/gender prevalence differences could be used to inform future models of CE burden.

Parasitic lung infection and the paediatric lung

Human parasitosis is still prevalent worldwide and causes significant morbidity and mortality in developing countries. The involvement of the lung is variable depending on the characteristics of the parasites and hosts. In malnourished and immunodeficient children, the consequences of lung parasitosis may result in significant morbidity and mortality.

[Surgical treatment of pulmonary hydatid cysts in childhood]

OBJECTIVES

To analyse the radioclinical forms of pulmonary hydatid cyst in children, and to evaluate the results of surgical treatment.

PATIENTS AND METHODS

During a period of 4 years (2002-2005), 26 surgical procedures were performed for pulmonary hydatid cyst in 23 children (16 boys and 7 girls, mean age 13, 5 years). Symptoms were chest pain (87%), broncho-pulmonary infection (32%) and hemoptysis (22%). Chest x-ray showed a non-complicated cyst in 62% of cases. The CT scan was performed in 15 cases (65%), mainly for complicated forms. Abdominal echography for all patients showed 3 hepatic localisations of hydatid cyst. All the patients underwent surgical treatment by thoracotomy.

RESULTS

In a total of 34 cysts, 21 were uncomplicated, 13 complicated (intra-bronchial rupture: 11 cases, pleural rupture: 2 cases). Cystectomy or pericystectomy were performed in 91% of cases, segmentectomy in 6% and a lobectomy in 3%. Decortication was done in the 2 pleural-ruptured cases. There was no mortality. One lower left lobe atelectasis was observed post-operatively.

CONCLUSION

Conservative surgical techniques for pulmonary hydatid cysts in children are preferred to parenchyma resection. In our practice the treatment of bilateral hydatidosis in 2 times decreases the complication rate.

Effect of capitonnage and cystotomy on outcome of childhood pulmonary hydatid cysts

OBJECTIVE

In this clinical retrospective study cystotomy and capitonnage were compared in patients with childhood pulmonary hydatid cysts with regard to postoperative period.

METHODS

Between 1990 and 2004, 60 children with pulmonary hydatid cysts were treated surgically. There were 33 boys and 27 girls aged from 3 to 16 years. Cystotomy and closure of bronchial openings were performed in all patients. The patients were divided into 2 groups. While the residual cyst cavity was closed by means of capitonnage in group A (n = 37), cystotomy was applied in group B (n = 23).

RESULTS

There was no mortality in either group. Chest tubes were removed after 3.59 +/- 1.04 days in group A and 5.83 +/- 2.84 days in group B. The hospital stay was 4.86 +/- 1.43 days for group A and 7.22 +/- 3.34 days for group B. Prolonged air leak was found in 2 children in group A and 7 children in group B. There was a significant difference between group A and group B with regard to chest tube removal time (P = .001), hospital stay (P = .003), development of prolonged air leak (P = .004), and all complications (P = .031). Follow-up information was available for 49 children, ranging from 13 to 86 months (mean, 56 months). Recurrence was seen in 2 children of group A and 1 child of group B during the follow-up period (P = .698).

CONCLUSION

Capitonnage for pulmonary hydatid cysts is superior to cystotomy because it reduces morbidity (especially prolonged air leak) and hospital stay.