Pulmonary echinococcosis (hydatidosis) in children: Results of surgical treatment

From 1986-1996, 33 children with 49 pulmonary hydatid cysts underwent surgi cal treatment in Vienna and Istanbul. Cysts were unilateral in 28 and bilat eral in 5 cases; unruptured cysts (URC) were diagnosed in 19 patients, and 14 children presented with ruptured cysts (RC). Ten patients had cysts in o ther organs (liver, spleen, central nervous system) in addition to pulmonar y cysts. Diagnosis was primarily based on chest X-ray and computed tomograp hy scan. In Austrian children, a new combination of serological tests was u sed successfully (71% positive). The standard surgical procedure was cystotomy followed by capitonnage. The main postoperative complications were fever and wound infection. There were two recurrences after a mean follow-up of 4.8 years, and one patient died because of multiple organ involvement. We conclude that the therapy of choice in pediatric pulmonary hydatidosis i s complete surgical elimination of the cyst by cystotomy and capitonnage, w hereas more extended resections should be avoided. Ideally, benzimidazole t reatment should be combined with surgery. New serological tests can improve diagnostic accuracy. (C) 1999 Wiley-Liss, Inc.