PERCUTANEOUS TREATMENT OF PULMONARY HYDATID CYSTS

Purpose: To evaluate the safety and efficacy of percutaneous drainage of pulmonary hydatid cysts. Methods: Eleven pulmonary hydatid cysts in eight patients were drained percutaneously after 1-2 years of treatme nt with mebendazole (50 mg/kg/day). Percutaneous needle aspiration was carried out under ultrasound (US) in six patients and computed tomogr aphy (CT) in two patients. Nine cysts were close to, and two cysts wer e distant from the thoracic wall. After aspiration, hypertonic (15%) s aline solution was instilled for up to 35% of the estimated volume of the cyst and aspirated 5-10 min later. Follow-up ranged from 8 to 31 m onths (mean 16.3 months). Results: Neither anaphylactic shock nor deat h occurred in any of the eight patients. One patient developed fever, ipsilateral hydropneumothorax, and contralateral pleural effusion. One patient suffered from fever, pneumothorax, and abscess and was treate d surgically; one developed fever and dyspnea. The volume reduction du ring follow-up was 47%-93%. The cystic contents turned into a pseudotu mor appearance with a thick irregular contour on CT and higher Hounsfi eld units. On US, the cysts showed a heterogeneous content with intern al echoes representing detached and degenerated membranes, and the flu id content almost completely disappeared. Conclusion: We believe that percutaneous therapy of pulmonary hydatid disease is an effective alte rnative to surgical treatment in patients who have failed medical ther apy.