HYDATIC CYSTS OF THE LIVER RUPTURING INTO THE THORAX - DIAGNOSTIC ANDTHERAPEUTIC ASPECTS

Hydatic cysts of the liver can rupture into the thorax. The aim of thi s work was to demonstrate how abdominal access can be used in most cas es. We report 44 cases of hydatic cysts which ruptured into the thorax among a series of 1411 hydatic cysts of the liver operated between 19 74 and 1995. Abdominal ultrasound and chest x-ray provided the diagnos is preoperatively in 35/42 operated cases (one case of spontaneous eli mination of a hydatic membrane via a cutaneous orifice and one case of preoperative death). Thoracophrenolaparotomy was used in 12 cases, th oractomy with laparotomy in 6, thoracotomy alone in 5 and laparotomy a lone in 19. Pulmonary resections were performed in 18 cases. No proced ure could be performed in one patient who died at the beginning of sur gery. A breach in the diaphragm was repaired in 41 cases. The dome of the cyst was resect in 29 cases and complete pericystectomy was perfor med in 12. There were 7 post-operative deaths. There were no deaths in the abdominal access patients. All emergency problems were controlled with abdominal access. Thoracic access was reserved for specific case s.