Treatment strategy for hydatid cysts with multiorgan involvement/localization

Hydatid cyst is a parasitic disease commonly observed in developing countries. In this study, 24 patients treated for multiorgan hydatid cyst disease in our clinic between 2001 and 2011 were retrospectively evaluated. Twenty patients had hydatid cysts in lungs and liver; one had cysts in heart, lungs, and liver; one had cysts in heart and lungs; and one had cysts on left diaphragm and liver. Twenty-one patients underwent posterolateral thoracotomy. In two patients, exploration was performed via median sternotomy. During thoracotomy, five cysts located in the right lung and liver were intervened with phrenotomy. Eighteen cysts were excised by using cystotomy plus capitonnage, four by cystotomy plus pericystectomy plus capitonnage, and two by enucleation. Five of the cases were ruptured hydatid cysts. Four of these patients had received 10 mg/kg/day albendazole treatment previously due to hydatid cyst of liver. The mean hospital stay was 17 days for ruptured cysts and 7 days for non-ruptured cysts. Preoperative medical treatment in patients with multiorgan hydatid cyst causes pulmonary cyst rupture, and eventually leads to morbidity. So, it is advisable that before starting medical treatment, the lungs should be screened for hydatid cysts.