Hamouri Shadi, Odat Haitham, Syaj Sebawe, Hecker Erich, Alrabadi Nasr
Department of General Surgery and Urology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.
Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.
Ann Med Surg (Lond). 2021 Jan 8;62:31-36. doi: 10.1016/j.amsu.2021.01.001. eCollection 2021 Feb.
Pulmonary hydatid cyst is a parasitic disease causing an endemic and a health burden in many regions. Lung cysts are more common than liver cysts in children and patients may remain asymptomatic. Cyst rupturing is not uncommon, and it is considered the most feared complication. In this cohort study, we aimed to identify the risk factors related to cyst rupture in a Jordanian pediatric population.
We retrospectively evaluated all pediatric patients who underwent cystostomy and capitonnage for pulmonary hydatid cyst between 2003 and 2020 at King Abdullah University Hospital.
We found 43 patients with a mean age of 13 ± 4 years who suffered from 61 pulmonary cysts. 55.6% of them were males. The most prevalent symptom was shortness of breath. The rupture rate for patients was 39.5%, and 29.5% for cysts. None of the patients with cyst rupture had an anaphylactic reaction. The left lower lobe was the most common location for both intact and ruptured cysts. 25.6% of the patients had giant cysts (>10 cm) with a mean of 7.4 cm for all cysts. Patients with intact cysts had higher-rates of cough (42.3% vs. 29.4%) and lower-rates of shortness of breath (34.6% vs. 52.9%) than patients with ruptured cysts, which were not statistically significant. Although statistically insignificant, patients with ruptured cysts tended to have multiple cysts in one lung (29.4% vs. 7.7%, p = 0.180), and more complication rates (29.4% vs 7.7%, p = 0.09). Both groups had almost identical IgG-ELISA positive results. We found no significant association between cyst rupture and age, gender, presenting symptoms, cyst size, cyst location, and rate of postoperative complications.
The rupture of pulmonary hydatid cyst has clinical consequences in pediatric patients, further studies on larger populations are needed to identify factors that make patients more prone to rupture and prioritize them for clinical monitoring and management.
肺包虫囊肿是一种寄生虫病，在许多地区都是地方病，给健康带来负担。在儿童中，肺囊肿比肝囊肿更常见，患者可能没有症状。囊肿破裂并不罕见，被认为是最可怕的并发症。在这项队列研究中，我们旨在确定约旦儿科人群中与囊肿破裂相关的危险因素。
我们回顾性评估了2003年至2020年期间在阿卜杜拉国王大学医院接受肺包虫囊肿囊肿造口术和囊内缝合术的所有儿科患者。
我们发现43例患者，平均年龄13±4岁，患有61个肺囊肿。其中55.6%为男性。最常见的症状是呼吸急促。患者的破裂率为39.5%，囊肿的破裂率为29.5%。囊肿破裂的患者均未发生过敏反应。左下叶是完整囊肿和破裂囊肿最常见的部位。完整囊肿患者的咳嗽发生率（42.3%对29.4%）高于破裂囊肿患者，呼吸急促发生率（34.6%对52.9%）低于破裂囊肿患者，但差异无统计学意义。虽然无统计学意义，但破裂囊肿患者倾向于一侧肺有多个囊肿（29.4%对7.7%，p = 0.180），并发症发生率更高（29.4%对7.7%），p = = 0.09）。两组的IgG-ELISA阳性结果几乎相同。我们发现囊肿破裂与年龄、性别、症状、囊肿大小、囊肿位置和术后并发症发生率之间无显著关联。
肺包虫囊肿破裂对儿科患者有临床影响，需要对更多人群进行进一步研究，以确定使患者更易发生破裂的因素，并将其作为临床监测和管理的重点。
