Arslan Banu, Sonmez Osman
Department of Emergency Medicine, Basaksehir Cam and Sakura City Hospital, Istanbul, TUR.
Cureus. 2022 May 28;14(5):e25431. doi: 10.7759/cureus.25431. eCollection 2022 May.
Pulmonary hydatid cyst during pregnancy is extremely rare and life-threatening for the mother and fetus. Throughout pregnancy, hydatid cysts may enlarge due to the suppression of cellular immunity and steroids secreted from the placenta. In late pregnancy, the cysts can reach a huge volume with an increased risk for subsequent rupture due to the compression of the enlarging uterus and anaphylactic shock. Intrabronchial rupture is a rare and life-threatening complication of pulmonary hydatid cysts. It is vital to diagnose it as early as possible and manage patients with surgical intervention with aggressive medical treatment. Plain radiograph, computed tomography (CT) scan, and magnetic resonance imaging (MRI) can be used to identify pulmonary hydatid cysts. However, the diagnosis of hydatid cyst is quite challenging in pregnant patients due to concerns of radiation. Herein, we present a 26-week pregnant patient with acute respiratory failure. Bedside lung ultrasound was notable for thickened and severely broken pleural line with a large subpleural consolidation, and a giant fluid-filled cyst covered almost the entire left thorax, causing a mediastinal shift. In the present case, we highlighted that the bedside lung ultrasound in emergency (BLUE) protocol is an easy, safe, and fast way to identify pulmonary hydatid cyst. It should be the initial technique of choice for the diagnosis of pulmonary hydatid cysts in pregnant patients.
妊娠期间的肺包虫囊肿极为罕见，对母亲和胎儿均有生命威胁。在整个孕期，由于细胞免疫受抑制以及胎盘分泌的类固醇作用，包虫囊肿可能会增大。在妊娠晚期，囊肿可能会变得巨大，由于增大的子宫压迫以及过敏反应，囊肿破裂的风险增加。支气管内破裂是肺包虫囊肿罕见且危及生命的并发症。尽早诊断并通过积极的药物治疗和手术干预来处理患者至关重要。胸部X线平片、计算机断层扫描（CT）和磁共振成像（MRI）可用于识别肺包虫囊肿。然而，由于担心辐射问题，对妊娠患者的包虫囊肿诊断颇具挑战性。在此，我们报告一例孕26周的急性呼吸衰竭患者。床旁肺部超声显示胸膜线增厚且严重中断，伴有大片胸膜下实变，一个巨大的液性囊肿几乎占据了整个左胸，导致纵隔移位。在本病例中，我们强调急诊床旁肺部超声（BLUE）方案是一种简便、安全且快速识别肺包虫囊肿的方法。它应成为妊娠患者肺包虫囊肿诊断的首选初始技术。
