Diagnosis and treatment of infected pulmonary hydatid cyst rupture into the pleural cavity in children
https://doi.org/10.52888/0514-2515-2026-369-2-61-71
Abstract
Objective: To improve the diagnostic and treatment strategy for infected pulmonary hydatid cysts complicated by rupture into the pleural cavity in pediatric patients.
Material and Methods: A retrospective and prospective cohort study was conducted on 140 children with complicated, infected pulmonary hydatid cysts, where rupture into the pleural cavity was diagnosed in 37 (26.4%) patients. The main group consisted of 24 patients (managed according to the developed algorithm), and the control group consisted of 13 patients (managed according to traditional methods). The study utilized general clinical, laboratory, radiographic, computed tomography (CT), bacteriological, histological, and statistical research methods.
Results: CT verified cyst rupture in 86.4% of cases. The developed algorithm includes comprehensive preoperative management using minor surgical techniques (puncture and thoracentesis for sanitation and decompression). In the main group, reliable stabilization of hematological parameters (decrease in leukocytes to 7.40±0.25 x10⁹/L), relief of endotoxicosis (mean survival time of Paramecium was 39.2±1.0 sec), and attenuation of systemic inflammatory response (LII 1.5±0.1 units) were achieved. Organ-preserving surgeries (echinococcectomy with subtotal pericystectomy) yielded good results in 66.9% of patients and satisfactory results in 33.1%.
Conclusions: Based on the identified clinical and morphological features, a diagnostic and treatment algorithm is proposed that enables early diagnosis, effective resolution of severe toxemia manifestations, and a differentiated approach to surgical intervention, thereby minimizing postoperative complications.
About the Authors
M. A. OripovTajikistan
Oripov Miraziz Anvarovich — Pediatric Surgeon, Researcher at the Department of Pediatric Surgery
tel.: +992918308568
Dushanbe
Kh. I. Ibodov
Tajikistan
Ibodov Khabibullo - Doctor of Medical Sciences, Professor of the Department of Pediatric Surgery
Dushanbe
R. R. Rofiev
Tajikistan
Rofiev Rauf Rofievich - PhD, professor. Professor of the Department of Pediatric Surgery and Anesthesiology
Dushanbe
References
1. Ksia A, et al. Clinical features and treatment of ruptured pulmonary hydatid cyst in children. The Turkish Journal of Pediatrics. 2020;62(4):578-583.
2. Minaev SV. Complicated hydatid disease in children: An 18-year experience. World Journal of Pediatric Surgery. 2021;4(3):2-84.
3. Sarkar S, Singh A, Sharma R. Complicated pulmonary hydatid cyst in children: A clinical, radiological and bronchoscopic paradigm. Journal of Pediatric Surgery. 2022;57(8):154-159.
4. Usluer O. Pneumothorax following rupture of pulmonary hydatid cyst. Interactive Cardiovascular and Thoracic Surgery. 2021;32(4):550–556.
5. Khadzhibaev AM, Rakhmanov RO, Vakhidov UKh, Shokirov FB. Diagnostics and surgical treatment of complicated pulmonary echinococcosis. Vestnik ekstrennoy meditsiny. 2015;1:5-9. (In Russ.).
6. Khamuri S., Odat Kh., Syadzh S., Kheker E., Alrabadi N. Rupture of pulmonary hydatid cyst in children: a cross-sectional study. Ann Med Surg (Lond). 2021;62:31-36. (In Russ.). DOI: 10.1016/j.amsu.2021.01.001.
7. Baibekov IM, Leonov FV. The phenomenon of localization of germinal elements of echinococcus and microorganisms in the fibrous capsule and its significance in the treatment and prevention of disease relapses. In: Surgery of echinococcosis: abstracts of the International Symposium. Khiva; 1994:6. (In Russ.).
8. Ismailov DA, Alimov MM, Baibekov IM, Tursunov NT, Mukhammadiev MN. Morphological aspects of the viability of echinococcal cysts during their suppuration. Khirurgiya Uzbekistana. 2009;3:24-28. (In Russ.).
9. Safonov DV, Safonova TD. Ultrasound diagnosis of purulent pleural effusions - pleural empyema and pyopneumothorax. Vestnik Natsionalnogo mediko-khirurgicheskogo Tsentra im. N.I. Pirogova. 2016;11(3):14-23. (In Russ.).
10. Vasin VA. Percutaneous drainage versus open surgery for infected hydatid cysts. Journal of Interventional Radiology. 2023;34(2):145–152.
11. Siles-Lucas M. New molecular targets for the treatment of echinococcosis. Frontiers in Cellular and Infection Microbiology. 2023;13:1123405.
12. Pulatov AT. Echinococcosis in childhood. Moscow: Meditsina; 2004:224. (In Russ.).
13. Zhang Y. Proteomic analysis of the pericyst in human hydatid disease. Parasitology International. 2024;98:102812.
14. Akilov Kh.A, Ismailov D.A. Lasers in lung surgery. Tashkent: Abu Ali Ibn Sino Publishing House; 2001:152. (In Russ.).
15. Dosmagambetov SP. Algorithm of the main stages of thoracoscopic lung echinococcectomy in children. Detskaya khirurgiya. 2011;3:32-35. (In Russ.).
16. Usmanov KhS, Salimov ShT. Choice of tactics for surgical treatment of children with pulmonary echinococcosis. Detskaya khirurgiya. 2023;27:190. (In Russ.).
17. Shamsiev ZhA, Shamsiev AM, Tagaev IU, Bobomurodov AN. On the treatment of echinococcosis in children. The Scientific Heritage. 2020;48(2):61-64. (In Russ.).
18. Chernousov AF, Musaev GKh, Abarshalina MV. Modern methods of surgical treatment of combined echinococcosis of the lungs and liver. Khirurgiya. 2012;7:12-18. (In Russ.).
Review
For citations:
Oripov M.A., Ibodov Kh.I., Rofiev R.R. Diagnosis and treatment of infected pulmonary hydatid cyst rupture into the pleural cavity in children. Health care of Tajikistan. 2026;(2):61-71. (In Russ.) https://doi.org/10.52888/0514-2515-2026-369-2-61-71
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