Correspondence to Author: Muhammad Shoaib Nabi, Zeeshan Sarwar; MBBS, Hassan Iftikhar MS. 

1. Muhammad Shoaib Nabi; FCPS (Thoracic Surgery), (Professor of Thoracic Surgery, Head of Department of Thoracic Surgery: Services Institute of Medical Sciences (SIMS), Services Hospital, Lahore, Pakistan)
2. Zeeshan Sarwar; MBBS, MRCS (Edinburgh) (Resident, Department of Thoracic Surgery, Services Hospital, Lahore, Pakistan)
3. Hassan Iftikhar; MS (Thoracic Surgery), (Senior Registrar, Department of Thoracic Surgery, Services Hospital, Lahore, Pakistan)

DOI: 10.52338/wjsurgy.2025.5220

ABSTRACT:

Objectives: Rupture of pulmonary hydatid cysts is an uncommon but serious complication with notable morbidity. Data on iatrogenic rupture remain limited, particularly in endemic regions. This study evaluated the clinical characteristics, management, and outcomes of patients with ruptured pulmonary hydatid cysts.
Methods: A retrospective study was conducted at the Thoracic Surgery Department of Services Hospital, Lahore, Pakistan, including 36 patients with iatrogenic or spontaneous cyst rupture from January 2021 to June 2025. Demographic, clinical, radiologic, surgical, and postoperative data were analyzed using descriptive and correlation statistics.
Results: The mean age was 34.3 ± 11.2 years; 24 (66.7%) were male. Chest pain (94.4%) was the most frequent symptom, followed by cough (41.7%) and hemoptysis (22.2%). Rupture was iatrogenic in 22 (61.1%) and spontaneous in 14 (38.9%) cases. Post-rupture complications included respiratory distress (77.8%) and anaphylaxis (38.9%). Surgical procedures included cystotomy with capitonnage in 17 (47.2%), lobectomy in 11 (30.6%), and cystotomy with decortication in 8 (22.2%). Larger or multiple cysts were significantly associated with lobectomy (p = 0.008). Postoperative complications occurred in 11.1% of patients, mean hospital stay was 5.9 ± 1.6 days, and mortality was nil.
Conclusion: Rupture of pulmonary hydatid cysts, especially iatrogenic rupture, is a rare but preventable event. Early diagnosis and prompt surgical management ensure excellent outcomes. Larger or multiple cysts significantly increase the need for lobectomy. This study provides valuable data from an endemic region to guide prevention and management strategies.

Citation:

Zeeshan Sarwar, Ruptured Pulmonary Hydatid Cysts: Surgical Challenges and Clinical Outcomes. World Journal of Clinical Surgery 2025.