Puri Deepak, Mandal Amit Kumar, Kaur Harinder Pal, Mahant Tek Singh
Fortis Hospital Mohali, 193, Phase XI, Mohali, Punjab 160062, India.
Case Rep Surg. 2011;2011:730604. doi: 10.1155/2011/730604. Epub 2011 Aug 15.
Ruptured pulmonary hydatid cyst may sometimes cause complications like empyema, bronchopleural fistula, and collapsed lung. These complications may mislead the diagnosis and treatment if prior evidence of cyst has not been documented before rupture. We present a case of a young male who presented with complete collapse of left lung with pyopneumothorax and bronchopleural fistula which was misdiagnosed as pulmonary tuberculosis. He was referred to us from peripheral hospital for pneumonectomy when his condition did not improve after six months of antitubercular chemotherapy and intercostals drainage. On investigation, CT scan revealed significant pleural thickening and massive pneumothorax restricting lung expansion. Decortication of thickened parietal and visceral pleura revealed a ruptured hydatid endocyst, and repair of leaking bronchial openings in floor of probable site of rupture in left upper lobe helped in the complete expansion of the collapsed lung followed by uneventful recovery.
破裂的肺包虫囊肿有时可能会引发如脓胸、支气管胸膜瘘和肺萎陷等并发症。如果在囊肿破裂前未记录囊肿的先前证据，这些并发症可能会误导诊断和治疗。我们报告一例年轻男性病例，该患者出现左肺完全萎陷伴脓气胸和支气管胸膜瘘，最初被误诊为肺结核。在接受抗结核化疗和肋间引流六个月后病情仍未改善，他从外周医院转诊至我们这里接受肺切除术。经检查，CT扫描显示胸膜显著增厚和大量气胸，限制了肺扩张。对增厚的壁层和脏层胸膜进行剥脱术时发现一个破裂的包虫内囊，对左肺上叶可能的破裂部位底部漏液的支气管开口进行修复，有助于萎陷肺完全复张，随后患者顺利康复。
