Marghli A, Ayadi-Kaddour A, Ouerghi S, Boudaya M S, Zairi S, Smati B, Mestiri T, Kilani T
Service de chirurgie thoracique et cardiovasculaire, hôpital Abderrahmen Mami de pneumophtisiologie, Ariana, Tunisia.
Rev Mal Respir. 2011 Mar;28(3):344-7. doi: 10.1016/j.rmr.2010.07.010. Epub 2011 Mar 1.
Hydatid cyst is a parasitic disease that is endemic in many countries. Pneumothorax may be a presentation of this disease that presents urgent problems of diagnosis and treatment.
We report the case of a 23-year-old woman, amenorrheic for 22 weeks, who presented with chest pain and dyspnoea. Chest x-ray revealed a right-sided tension pneumothorax. A check x-ray after drainage showed a homogeneous opacity of water density occupying the lower 2/3 of the right hemithorax. Thoracic ultrasound suggested an uncomplicated hydatid cyst at the right base. Surgical exploration revealed a hydatid cyst 14cm in diameter in the pleural space, and a cavity in the right lower lobe with two bronchial fistulae. Treatment consisted of removal of the cyst intact, closure of the bronchial fistulae and capitonnage of the residual cavity. The postoperative course was uncomplicated.
Primary heterotopic pleural hydatid cyst is an exceptional cause of pneumothorax that should considered in countries where hydatid disease is endemic. Treatment is surgical following drainage of the pneumothorax.
包虫囊肿是一种在许多国家流行的寄生虫病。气胸可能是该疾病的一种表现形式，会带来诊断和治疗方面的紧迫问题。
我们报告一例23岁女性患者，停经22周，出现胸痛和呼吸困难。胸部X线显示右侧张力性气胸。引流后复查X线显示右半胸下2/3区域有均匀的水样密度影。胸部超声提示右肺底部有一个单纯性包虫囊肿。手术探查发现胸膜腔内有一个直径14厘米的包虫囊肿，右下叶有一个伴有两个支气管瘘的空洞。治疗包括完整切除囊肿、封闭支气管瘘以及对残留空洞进行填充。术后过程顺利。
原发性异位胸膜包虫囊肿是气胸的一种罕见病因，在包虫病流行的国家应予以考虑。气胸引流后采用手术治疗。
