EC Pulmonology and Respiratory Medicine

Hepatic hydatid cyst (HHC) ruptured in the chest is a well-known complication in endemic areas for hydatidosis. The rupture can be in the pleural space or in the lung parenchyma through a bilio-bronchial fistula (BBF). Biliptysis is the main reported symptom and signifies the presence of BBF. The disease is associated to non-negligible rates of morbidity and mortality. However, preparation of patients for surgery and the increase use of endoscopic retrograde cholangiography have allowed the decrease of these rates. When the HHC is localized in the seventh or eighth liver segments, an intervention by thoracotomy facilitates the cure of the three anatomical levels affected (liver, diaphragm, and lung).

 Keywords: Hydatid Cyst; Liver; Endoscopic Retrograde Cholangiography; Bilio-Bronchial Fistula; Thoracotomy; Thoracic Surgery

1. Harmouchi H., et al. “Indications of anatomical lung resection in the pulmonary hydatid cyst: About 21 cases”. Journal of Liver and Clinical Research 2 (2018): 1048.
2. Mohammed Laytimi F. “le kyste hydatique du poumon chez l’enfant à propos de 115 cas faculté de médecine et de pharmacie de FES”. Thèse de médecine, N°064/11 (2011).
3. Shaw JM., et al. “Hydatid disease of the liver”. South African Journal of Surgery 2 (2006): 70-72, 74-77.
4. Shaikh O., et al. “Hepatic hydatid cyst with cystobiliary communication and cystoduodenal fistula”. Cureus 8 (2021): e17473.
5. Rabiou S., et al. “Management for ruptured liver hydatid cysts in the chest: experience of a Moroccan center”. Clinics in Surgery 2 (2017): 1757.
6. Kilani T., et al. “Hydatid disease of the liver with thoracic involvement”. World Journal of Surgery 1 (2001): 40-45.
7. Mestiri S., et al. “Thoracic migrations of hydatid cysts of the liver: proposal for a classification”. Lyon Chir. 83 (1987): 12-16.
8. Dietrich CF., et al. “Cystic and alveolar echinococcosis of the hepatobiliary tract - the role of new imaging techniques for improved diagnosis”. Medical Ultrasonography 1 (2020): 75-84.
9. Little AF., et al. “MR cholangiography in the evaluation of suspected intrabiliary rupture of hepatic hydatid cyst”. Abdominal Radiology 3 (2002): 333-335.
10. Yaşar Z., et al. “Diagnosis of pulmonary hydatid cyst by bronchoscopy”. Journal of Bronchology and Interventional Pulmonology 4 (2015): 343-346.
11. Komurcuoglu B., et al. “Pulmonary hydatid cyst: The characteristics of patients and diagnostic efficacy of bronchoscopy”. Experimental Lung Research 6 (2012): 277-280.
12. Stojkovic M., et al. “Endoscopic treatment of biliary stenosis in patients with alveolar echinococcosis--Report of 7 consecutive patients with serial ERC approach”. PLOS Neglected Tropical Diseases 2 (2016): e0004278.
13. Rabiou S., et al. “Surgical management of hydatid Bilio-bronchial fistula by exclusive thoracotomy”. International Journal of Surgery 41 (2017): 112-118.
14. Guzmán-Calderón E. “Complete extraction of a long hepatic hydatid cyst with endoscopic retrograde cholangiography”. Revista Española de Enfermedades Digestivas 8 (2021): 621.
15. Marshall K and McLaughlin K. “Pain management in thoracic surgery”. Thoracic Surgery Clinics3 (2020): 339-346.
16. Dhaliwal RS and Kalkat MS. “One-stage surgical procedure for bilateral lung and liver hydatid cysts”. Annals of Thoracic Surgery 2 (1997): 338-341.
17. Aghajanzadeh M., et al. “One-stage procedure for lung and liver hydatid cysts”. Asian Cardiovascular and Thoracic Annals 5 (2008): 392-395.
18. Rabiou S., et al. “Le chirurgien thoracique face à la fistule biliobronchique d’origine hydatique The thoracic surgeon and the management of the bronchial biliary fistula of hydatid origin”. Revue de Pneumologie Clinique 1 (2018): 41-47.
19. Rabiou S., et al. “Localisation gauche d’une fistule biliobronchique : complication exceptionnelle de l’hydatidose hépatique Left localization of biliobronchial fistula: Exceptional complication of hepatic hydatidosis”. Revue de Pneumologie Clinique 6 (2018): 502-507.