Ruptured liver hydatid cyst into the thorax : surgical management and follow up

<bold>Introduction:</bold> Hepatic hydatid cyst is a prevalent parasitic infection, typically carrying a favorable prognosis if treated promptly. Nonetheless, thoracic migration poses a significant complication with notable mortality and morbidity. Cysts in proximity to the diaphragm are particularly prone to this complication <bold>Results:</bold> Our study enrolled a total of 76 patients, consisting of 39 females and 37 males, with a sex ratio of 0.94. The mean age of the patients was 48.22 years. Preoperative antibiotic therapy was administered to 32 patients, and 11 patients underwent preoperative thoracic drainage. The most common surgical approach was right posterolateral thoracotomy, performed in 85.52% of cases. Left posterolateral thoracotomy was performed in only 2 patients, while 5 patients underwent a double thoracotomy through the same skin incision, 2 patients underwent both thoracic and abdominal approaches, and 1 patient underwent an abdominal approach alone through a subcostal incision. Surgical procedures included planned pulmonary resection in 28.57% of cases, wedge pulmonary resection in 28.57% of cases, sole decortication in 23.8% of cases, and secondary pleural hydatidosis cure in 11.1% of cases. Diaphragmatic perforation was singular in 59 patients, with an average size of 3.5 cm. The average duration of drainage was 12 days. Postoperative complications occurred in 13 patients, and there were 3 deaths, resulting in a hospital mortality rate of 3.94% <bold>Conclusion:</bold> It is evident that surgical intervention remains the primary treatment modality for managing thoracic migration of hepatic hydatid cysts