Echinococcal lung abscess surgical considerations

Abstract AR

Objectives .: The purpose of the .study was to determine the most common cause of lung abscess in Iraqi patients and the safest approach to the surgical management of echinococcal lung abscess.

Methods : The case records of patients with pulmonary hydatid disease who were seen at the Medical City Teaching Hospital in Baghdad during a period of 2 years from 1996 to 1998 were reviewed.

In addition, the records of all patients who had undergone resection for lung abscesses during the same period were reviewed.

Results: There were 187 patients with pulmonary hydatid cysts.

Eighty-three patients presented with intact hydatid cyst; in 104 patients, the cysts were complicated by rupture and infection.

Of these, only 23 patients presented with lung abscess.

These were in the 26 to 50 years of age group.

Fifteen were male and eight were female.

Ten presented with acute lung abscess and underwent staged operation.

A complete cure was accomplished in 22 patients.

One patient died with septicemia following empyema and bronchopleural fistula.

There were 48 patients with lung abscess during this period.

In addition to the 23 with echinococcal abscesses, there were 11 malignant abscesses, 10 postpneumonic abscesses, and 4 tuberculous abscesses.

Conclusion: Hydatid cyst is the most common cause of lung abscess in Iraq.

Staged operation is the safest method in dealing with acute lung abscesses.