[Diaphragmatic hydatidosis: Report of a series of 27 cases].

OBJECTIVES

To analyze the clinical, radiological and treatment of this rare disease and assess the results of surgical treatment by thoracotomy.

PATIENTS AND METHODS

In the period of 10 years (1990-1999), 27 patients (15 males and 12 females, mean age: 32,4) underwent surgical treatment for hydatid cyst of the diaphragm with or without other location. Clinical signs were chest pain and dyspnea. Diagnosis was by abdominal echography and thoracic CT in 82% of cases. Surgical treatment was given alone in 25 cases, completed by medical care in 2.

RESULTS

Diaphragmatic cyst was simple in 17 cases and complicated in 10: intrapleural rupture (4 cases), pulmonary hydatid cyst association (3 cases), hepatic cyst (2 cases) and disseminated form (1 case). Resection of the dome and pericystectomy were the used surgical procedures. Pneumothorax was the only post-operative complication (3.7%). The mortality was nil.

CONCLUSION

Diaphragmatic hydatidosis requires a careful topographic diagnosis between the lung, diaphragm, liver or abdominal localizations. Ultrasound and computed tomography are highly contributive. Surgery is the best treatment, thoracotomy being an excellent approach.