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尺寸至关重要:小儿巨大肺包虫囊肿的管理:病例报告

When size matters: Managing a giant pulmonary hydatid cyst in a pediatric patient: Case report.

作者信息

Abu Mayyaleh Haya, Abu-Radwan Bayyena, Jadallah Islam, Saleh Mohammed, Fasfoos Ahmad, Abu Asbeh Yousef

机构信息

Faculty of Medicine, Hebron University, Hebron, Palestine.

Department of thoracic surgery, Al-Ahli Hospital, Hebron, Palestine.

出版信息

Medicine (Baltimore). 2025 Sep 12;104(37):e44212. doi: 10.1097/MD.0000000000044212.

Abstract

RATIONALE

Giant pulmonary hydatid cysts in children are rare, with nonspecific symptoms often delaying diagnosis. Preservation of lung parenchyma during surgery is essential. This is the first reported case of such a cyst in a Palestinian pediatric patient.

PATIENT CONCERNS

A 5-year-old girl presented with progressive left flank pain, dyspnea, and fever; initially misdiagnosed as gastroenteritis.

DIAGNOSES

Chest X-ray and computed tomography revealed a hydatid cyst occupying >90% of the left lower lung lobe with pleural effusion.

INTERVENTIONS

Urgent lateral thoracotomy combined with video-assisted thoracoscopic surgery was performed for cyst evacuation and sterilization, preserving lung parenchyma.

OUTCOMES

Successful removal with uneventful recovery; discharged in stable condition after 6 days.

LESSONS

Early imaging and diagnosis are critical. Hybrid surgical approaches can remove large cysts while preserving lung tissue. Hydatid disease should be considered in children with unexplained respiratory or gastrointestinal symptoms in endemic regions.

摘要

原理

儿童巨大肺包虫囊肿罕见,非特异性症状常导致诊断延迟。手术中保留肺实质至关重要。这是首例报道的巴勒斯坦儿科患者出现此类囊肿的病例。

患者情况

一名5岁女孩出现进行性左胁腹痛、呼吸困难和发热;最初被误诊为肠胃炎。

诊断

胸部X光和计算机断层扫描显示一个包虫囊肿占据左下肺叶超过90%并伴有胸腔积液。

干预措施

紧急行侧开胸手术并结合电视辅助胸腔镜手术以排出囊肿并进行消毒,同时保留肺实质。

结果

成功切除,恢复顺利;6天后病情稳定出院。

经验教训

早期影像学检查和诊断至关重要。混合手术方法可在保留肺组织的同时切除大囊肿。在流行地区,对于有不明原因呼吸或胃肠道症状的儿童应考虑包虫病。

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