Search

The optimal management of simple hepatic cysts (SHCs) remains controversial. A retrospective review was carried out to evaluate the clinical presentation and surgical consideration of children with SHCs and outcome of management at our institution. We performed a retrospective review of all patients diagnosed with SHCs between January 1993 and May 2013. Patient variables included prenatal findings, age, gender, presenting symptoms, signs and diagnostic modality. Operative management and nonoperative follow-up were abstracted. The 67 patients comprised 42 females and 25 males: 16 had prenatally detected, and 51 had postnatally detected hepatic cysts with a mean follow-up of 3.2 years (10 months−12 years). The average age was 5.9 years (0−17 years). Ten patients (six females and four males) were treated surgically. Fifty-seven asymptomatic patients were observed. Of those 57 patients, 9 (17 %) had enlarged cysts, and 1 (2 %) had clinical signs. The average enlargement time was 36 months (6−67 months). The cysts occurred in the right lobe in 47 patients, in the left lobe in 17 patients and in both lobes in 3 patients. The median cyst size for the asymptomatic cases was 2.1 cm (1.5−6 cm) and 13.7 cm (8−25 cm) for the surgery group. A statistically significant difference in cyst size was found between these two groups (p

Purpose While several publications have reported the treatment of ruptured lung hydatid cysts (HC) in adults, there is limited information on the treatment of children. This study summarizes the treatment approach and outcomes of 11 children with spontaneous rupture of lung HCs into a bronchus. Methods The complete medical records of 11 patients with spontaneous lung HC bronchus rupture between March 1993 and April 2012 were examined retrospectively. Gender, age at the time of diagnosis, patient symptoms, lung localization, dimensions of the cyst, medical treatment duration, and associated morbidities were evaluated. Routine chest x-rays, ultrasonography, computed tomography and serological tests were used. Result The study included 11 patients [4 males, 7 females; average age 7.45 (range 5–11) years] presenting to the Emergency Department. The symptoms at the time of presentation were coughing in 81.8% ( n =9), hemoptysis in 54.5% ( n =6), and chest pain in 54.5% (n=6). The average cyst diameter was 8.71(35–15) cm. The rupture involved the left lung in 7 (63.6%) patients and the right in 4 (36.4%). Serological tests were positive in seven patients and all patients had eosinophilia. The treatment of one patient was discontinued, while all of the other patients were treated medically. Pneumonia developed in four patients and lung abscesses in two. Both patients who developed lung abscesses had cysts with diameters greater than 10cm. The average follow-up period was 48.4 (range 15–85) months; no mortality occurred. Conclusion In our experience, medical treatment is adequate for patients with lung HCs progressing to spontaneous bronchus rupture. There was a high rate of abscess development within the thoracic cavity in patients with cysts over 10cm in diameter; these patients can be treated effectively with a medical approach.