Management of secondary pleural hydatidosis : a 30-year experience

<bold>Introduction:</bold> Hydatidosis is caused by the development of echinococcus granulosus larvae in humans. The lung is the 2nd most common site after the liver. The pleural site is often secondary to rupture of a supra- or sub-diaphragmatic hydatid cyst. Primary pleural location is rare <bold>Methods:</bold> Retrospective descriptive study of 98 patients operated on for secondary pleural hydatidosis in the thoracic surgery department of the Abderrahmen Mami Hospital in Ariana over a period of 30 years. <bold>Results:</bold> The patients were 59 men and 39 women, with a mean age of 36 years [7→76]. The circumstances of discovery were chest pain in 82 cases, an associated cough in 67 cases, an incidental finding in 16 cases as part of a regular postoperative check-up of the pulmonary hydatid cyst, sepsis was present in 12 patients, 3 of whom were in a state of septic shock. All patients had a CT scan demonstrating the presence of pleural hydatidosis.23 patients had a ruptured liver dome hydatid cyst in the pleura , 4 patients had a primary pleural hydatid cyst , 55 patients had a ruptured lung hydatid cyst in the pleura , and 16 cases had pleural hydatidosis secondary to surgery for a lung hydatid cyst. The treatment was surgery in 100% of cases. The surgical approach was posterolateral thoracotomy in 69 cases, lateral thoracotomy in 18 cases and video-thoracoscopy in 11 cases. The postoperative course was straightforward in 89 cases, with 3 cases of death following septic shock, 2 cases of postoperative haemothorax and 4 cases of pleural empyema <bold>Conclusion:</bold> Our study shows that pleural hydatidosis is often associated with an underlying pulmonary hydatid cyst. We insist on prevention as the best means of eradicating this disease.